Individual
MELISSA GIPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
Mailing address
1080 BILL BACOT RD, MCCOMB, MS 39648-8458
(601) 942-1127
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0644
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S0644
MISSISSIPPI STATE HEALTH LICENSE
MS
Enumeration date
09/21/2016
Last updated
09/21/2016
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