Individual
MRS. JENNIFER FARRAGUT MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC-SLP
Contact information
Practice address
137 BEECHWOOD DR, HATTIESBURG, MS 39402-1442
(601) 466-0876
(601) 579-0283
Mailing address
137 BEECHWOOD DR, HATTIESBURG, MS 39402-1442
(601) 466-0876
(601) 579-0283
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2463
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00429208
—
MS
Enumeration date
02/12/2007
Last updated
05/25/2011
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