Organization
THERAPY NOOK PC
Active
Other names
Therapy Nook PC
Organization subpart
No
Provider details
NPI number
Authorized official
MILLICENT SMITH PORTER SLP (OWNER)
(601) 757-0766
Entity
Organization
Contact information
Practice address
520 SCHWEM AVENUE, BROOKHAVEN, MS 39601
(601) 990-4085
Mailing address
3054 JACKSON LIBERTY RD, WESSON, MS 39191
(601) 757-0766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12159923
MS
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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