Individual
MARY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4017
MS
Other
Enumeration date
02/23/2017
Last updated
02/23/2017
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