Individual
MRS. JENNA LEIGH NASSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5160
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5160
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3352
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07701558
—
MS
Enumeration date
09/29/2014
Last updated
12/10/2014
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