Individual
STACEY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3261 HIGHWAY 49, COLLINS, MS 39428-3876
(601) 921-6043
(601) 921-6044
Mailing address
599C STEED RD, RIDGELAND, MS 39157-1707
(601) 605-6777
(601) 813-5460
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3440
MS
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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