| Organization Name: | DELTA SPEECH-LANGUAGE PATHOLOGY, PLLC |
| NPI Number: | 1235502196 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER MELISSA MANGRUM (SPEECH PATHOLOGIST/OWNER) |
| Mailing Address: | 139 W Lake Lee Rd Greenville |
| State: | MS US |
| Postal Code: | 387019573 |
| Phone Number: | 6628221322 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2015 |
| NPI Last Update Date: | 11/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| 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 |