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Individual

AMETHYST WHITLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
711 LAKE HARBOUR DR, #1140, RIDGELAND, MS 39157-4300
(601) 906-6888
Mailing address
711 LAKE HARBOUR DR, #1140, RIDGELAND, MS 39157-4300
(601) 906-6888

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2013002841
MO
235Z00000X
Speech-Language Pathologist
Primary
S3718
MS

Other

Enumeration date
06/17/2013
Last updated
06/17/2013
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