Individual
STEPHANIE MACHELLE AULTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
100 W FRONT ST, HATTIESBURG, MS 39401-3460
(601) 270-6968
Mailing address
PO BOX 49, HATTIESBURG, MS 39403-0049
(601) 270-6968
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2122
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122690
—
MS
Enumeration date
02/05/2007
Last updated
07/08/2007
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