Individual
MISS ERICA TULLOS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
322 HIGHWAY 80 E, SUITES 10 & 11, CLINTON, MS 39056
(601) 460-0910
(601) 460-0911
Mailing address
921 W BEACON STREET, PHILADELPHIA, MS 39350
(601) 650-0002
(601) 650-9902
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-3095
MS
235Z00000X
Speech-Language Pathologist
S3095
MS
Other
Enumeration date
04/25/2008
Last updated
02/17/2022
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