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NPI Code Detail

MEDICARE: MRS. JUDY W. HEARNE MCD,CCC-SLP

MEDICARE:  MRS. JUDY W. HEARNE  MCD,CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistS0166MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2685381OTHERMSACN

General Provider Information

NPI Number : 1578782736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDY W. HEARNE MCD,CCC-SLP
Provider Business Mailing Address
First Line : 102 INDUSTRIAL PARK CIR
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5836
Country : US
Telephone Number : 228-872-0705
Fax Number : 228-872-6996
Provider Business Practice Location Address
First Line : 102 INDUSTRIAL PARK CIRCLE
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5836
Country : US
Telephone Number : 228-872-0705
Fax Number : 228-872-6996
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JUDY W. HEARNE MCD,CCC-SLP” Practice Location

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