Individual
SIEDAH AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4836 CHASTAIN DR, JACKSON, MS 39206-5062
(601) 454-4877
Mailing address
4836 CHASTAIN DR, JACKSON, MS 39206-5062
(601) 454-4877
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3711
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12150448
AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
MD
Enumeration date
06/01/2015
Last updated
06/01/2015
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