Organization
SPEECH THERAPY FOR KIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA LONG DAVIS M.S., CCC-SLP (OWNER)
(662) 574-2634
Entity
Organization
Contact information
Practice address
501 HIGHWAY 12 W STE A&D, STARKVILLE, MS 39759-3654
(662) 574-2634
(662) 338-5439
Mailing address
923 LIVE OAK LN, STARKVILLE, MS 39759-8565
(662) 574-2634
(662) 338-5439
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2545
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07384811
—
MS
Enumeration date
11/23/2009
Last updated
11/23/2009
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