Doctor Name: | VICKI LAVERNE MERRITT |
NPI Number: | 1063605459 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | S2410 |
Business Practice Address: | 13 Northtown Dr Suite 110 Trinity Rehab Jackson, ME - 39211 |
Business Phone Number: | 6012069195 |
Business Fax Number: | 6019578391 |
Mailing Address: | Po Box 315, Trinity Rehab RIDGELAND |
State: | MS |
Postal Code: | 39158 |
Phone Number: | 6012069195 |
Fax Number: | 6019578391 |
NPI Enumeration Date: | 08/20/2007 |
NPI Last Update Date: | 08/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S2410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |