Individual
MRS. ANGELA S GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
7302 HIGHWAY 613, MOSS POINT, MS 39563-9373
(228) 369-6493
(228) 460-5120
Mailing address
25001 STATE LINE RD, LUCEDALE, MS 39452-8351
(122) 836-9649
(228) 460-5120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3504
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12084074
AMERICAN SPEECH AND HEARING ASSOCIATION
MS
01
—
S3504
MS SLP LICENSE
MS
Enumeration date
01/18/2007
Last updated
05/16/2022
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