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Individual

JANICE VICTORIA SHOOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.,CCC-SLP

Contact information

Practice address
119 OLSON AVE, LONG BEACH, MS 39560-5825
(228) 860-4407
Mailing address
119 OLSON AVE, LONG BEACH, MS 39560-5825
(228) 860-4407

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0575
MS
235Z00000X
Speech-Language Pathologist
SP001495
TN

Other

Enumeration date
01/12/2010
Last updated
01/12/2010
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