Individual
LEAH FOXWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
Mailing address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2060
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167013
MS EDUCATOR LICENSE
MS
01
—
S2060
MS HEALTH LICENSE
MS
Enumeration date
11/03/2015
Last updated
11/03/2015
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