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Individual

LARUALEE FANT NOWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
(662) 349-8757
Mailing address
83 AIRWAYS PL, SOUTHAVEN, MS 38671-5885
(662) 349-8787
(662) 349-8757

Taxonomy

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

Other

Enumeration date
08/16/2018
Last updated
08/16/2018
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