Doctor Name: | ANN BETH BAILEY VANDERLOO |
NPI Number: | 1336331446 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ST |
License Number: | S0859 |
Business Practice Address: | 950 E County Line Rd Suite E Ridgeland, MS - 391571928 |
Business Phone Number: | 6018539747 |
Business Fax Number: | 6018984761 |
Mailing Address: | 950 E County Line Rd, Suite E RIDGELAND |
State: | MS |
Postal Code: | 391571928 |
Phone Number: | 6018539747 |
Fax Number: | 6018984761 |
NPI Enumeration Date: | 08/13/2007 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S0859 |
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 |