Individual
CARLA CHISM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
2564 HIGHWAY 345, PONTOTOC, MS 38863
(662) 419-0934
Mailing address
2564 HIGHWAY 345, PONTOTOC, MS 38863
(662) 419-0934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3362
MS
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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