| Doctor Name: | MS. JODI BAILEY |
| NPI Number: | 1770949042 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CF SLP |
| License Number: | S3991 |
| Business Practice Address: | 7160 Tchulahoma Rd Bldg. B, Ste. 4 Southaven, MS - 386719266 |
| Business Phone Number: | 6623492733 |
| Business Fax Number: | 6625361849 |
| Mailing Address: | 7160 Tchulahoma Rd, Bldg. B, Ste. 4 SOUTHAVEN |
| State: | MS |
| Postal Code: | 386719266 |
| Phone Number: | 6623492733 |
| Fax Number: | 6625361849 |
| NPI Enumeration Date: | 01/02/2016 |
| NPI Last Update Date: | 01/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S3991 |
| 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 |