Individual
MS. DEBORAH DAVIS KILGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3302 WOODLANDS PL, VICKSBURG, MS 39180-5758
(601) 638-2771
Mailing address
3302 WOODLANDS PL, VICKSBURG, MS 39180-5758
(601) 638-2771
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0762
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01002176
ASHA
MS
01
—
S0762
MISS. STATE BOARD OF HEAL
MS
Enumeration date
01/12/2008
Last updated
01/12/2008
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