Doctor Name: | MS. KYNA ROBINSON WOOLLERY |
NPI Number: | 1114286234 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | S2537 |
Business Practice Address: | 6348 Ellyn Cv Horn Lake, MS - 386372469 |
Business Phone Number: | 6623423635 |
Business Fax Number: | 6623428687 |
Mailing Address: | Po Box 932, HORN LAKE |
State: | MS |
Postal Code: | 386370932 |
Phone Number: | 6623423635 |
Fax Number: | 6623428687 |
NPI Enumeration Date: | 05/09/2012 |
NPI Last Update Date: | 05/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S2537 |
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 |