Individual
MRS. TERESA KAY LANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC SLP
Contact information
Practice address
4500 I-55 N, SUITE 291, JACKSON, MS 39211
(601) 362-0859
Mailing address
1074 LIVINGSTON VERNON RD, FLORA, MS 39071-9646
(601) 879-9962
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3157
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00479867
—
MS
Enumeration date
05/04/2007
Last updated
07/09/2007
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