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Organization

MISSISSIPPI STATE UNIVERSITY

Active
Parent organization
MISSISSIPPI STATE UNIVERSITY
Other names
Autism and Developmental Disabilities Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
MISSISSIPPI STATE UNIVERSITY
Authorized official
MARTHA LEIGH THOMAS (BUSINESS DIRECTOR)
(662) 325-1028
Entity
Organization

Contact information

Practice address
695 BULLY BLVD, MISSISSIPPI STATE, MS 39762
(662) 325-1028
Mailing address
PO BOX 9736, MISSISSIPPI STATE, MS 39762-9736

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Enumeration date
01/06/2025
Last updated
10/31/2025
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