Organization Name: | SPECIALIZED SPEECH THERAPY |
NPI Number: | 1215395793 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARRIE JOYCE PAYNE-MORRIS (SPEECH-LANGUAGE PATHOLOGIST) |
Mailing Address: | 14553 S Country Wood Dr Gulfport |
State: | MS US |
Postal Code: | 395038716 |
Phone Number: | 2288610584 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2016 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S1120 |
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 |