=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902020001
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARCI E AMES MS,CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2007
-----------------------------------------------------
Last Update Date | 06/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 SGT PRENTISS DR SUITE 8
-----------------------------------------------------
City | NATCHEZ
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39120-4782
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-446-8764
-----------------------------------------------------
Fax | 601-446-8745
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1401 AMES RD
-----------------------------------------------------
City | JONESVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71343-5201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-386-7214
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | S2962
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 6077
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------