Individual
LILLIAN HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
311 LAKE CASTLE RD, MADISON, MS 39110-8606
(601) 624-6292
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 624-6292
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4592
MS
Other
Enumeration date
05/08/2020
Last updated
09/04/2020
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