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Organization
THERAPY NOOK PC
Active
Organization
THERAPY NOOK PC
Active
Other names
Therapy Nook PC
Organization subpart
No
Provider details
NPI number
Authorized official
MILLICENT SMITH PORTER SLP (OWNER)
(601) 757-0766
Entity
Organization
Contact information
Practice address
520 SCHWEM AVENUE, BROOKHAVEN, MS 39601
(601) 990-4085
Mailing address
3054 JACKSON LIBERTY RD, WESSON, MS 39191
(601) 757-0766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12159923
MS
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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