Individual
ANN BETH BAILEY VANDERLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
950 E COUNTY LINE RD, SUITE E, RIDGELAND, MS 39157-1928
(601) 853-9747
(601) 898-4761
Mailing address
950 E COUNTY LINE RD, SUITE E, RIDGELAND, MS 39157-1928
(601) 853-9747
(601) 898-4761
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0859
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123119
—
MS
Enumeration date
08/13/2007
Last updated
11/03/2015
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