Individual
LEANNA MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1842 SIMPSON HIGHWAY 149, MENDENHALL, MS 39114-3438
(601) 847-5547
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4054
MS
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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