Individual
GINA JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
410 WALNUT STREET, BENOIT, MS 38725
(662) 843-2339
(662) 846-1397
Mailing address
410 WALNUT STREET, BENOIT, MS 38725
(662) 843-2339
(662) 846-1397
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2316
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04823044
—
MS
Enumeration date
01/08/2007
Last updated
07/08/2007
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