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Organization subpart
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Provider details

NPI number
Authorized official
MISS DELISHA DIANE SPEECH CCC-SLP (SPEECH LANGUGE PATHOLOGIST)
(601) 201-9313
Entity
Organization

Contact information

Practice address
1 PROFESSIONAL PKWY, SUITE 1B, RIDGELAND, MS 39157-4236
(601) 201-9313
(601) 790-7101
Mailing address
1 PROFESSIONAL PKWY, SUITE 1B, RIDGELAND, MS 39157-4236
(601) 201-9313
(601) 790-7101

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2982
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07326861
—
MS
Enumeration date
12/30/2016
Last updated
12/30/2016
About Stedi
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