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Organization

MAGNOLIA THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY BROWN CORBAN MS, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(662) 579-8508
Entity
Organization

Contact information

Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 579-8508
(601) 586-8334
Mailing address
206 SYCAMORE ST, LELAND, MS 38756-3139
(662) 820-5044

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07509591
MS
Enumeration date
04/09/2021
Last updated
05/23/2022
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