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General NPI Number Information
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NPI Number | 1811071772
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Entity Type | Individual
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Provider Name | JEAN MALONEY LALOR M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4500 I-55 N SUITE 291, HIGHLAND VILLAGE
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City | JACKSON
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State | MS
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Zip | 39211
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Country | US
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Telephone | 601-362-0859
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Fax |
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Provider Business Mailing Address
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Address Line | 761 RICE RD APT. 1012
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City | RIDGELAND
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State | MS
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Zip | 39157-1093
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Country | US
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Telephone | 601-421-2633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S0634
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License Number State | MS
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