Individual
MS. ANDREA CAROL STATEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
146 YOCONA RIDGE RD, OXFORD, MS 38655-6904
(662) 934-9885
Mailing address
146 YOCONA RIDGE RD, OXFORD, MS 38655-6904
(662) 934-9885
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2354
MS
Other
Enumeration date
08/17/2014
Last updated
11/10/2014
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