Individual
MRS. KIMANDRIA FUTRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1929 SPILLWAY RD STE A, BRANDON, MS 39047-6079
(601) 992-5370
(601) 992-5370
Mailing address
133 WOODBURY PARK PL, MADISON, MS 39110-8191
(601) 605-4878
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S1040
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09625729
—
MS
Enumeration date
04/25/2007
Last updated
07/09/2007
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