Individual
AMAYA ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
4722 SATINWOOD ST, JACKSON, MS 39212-5857
(601) 717-3712
Mailing address
4722 SATINWOOD ST, JACKSON, MS 39212-5857
(601) 717-3712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
202501954
MO
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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