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Individual

MRS. CARRIE ELIZABETH STEPHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
608 MCLARTY RD, OXFORD, MS 38655-4500
(662) 279-1938
Mailing address
120 BRECKENRIDGE DR, OXFORD, MS 38655-7502
(662) 279-1938

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3889
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14037137
AMERICAN SPEECH LANGUAGE AND HEARING ASSOCIATION
MS
01
259473
MISSISSIPPI EDUCATOR LICENSE
MS
01
S3889
STATE LICENSE SPEECH LANGUAGE PATHOLOGY
MS
Enumeration date
02/14/2017
Last updated
02/14/2017
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