Organization
MISSISSIPPI STATE UNIVERSITY
Active
Parent organization
MISSISSIPPI STATE UNIVERSITY
Other names
T.K. Martin Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSISSIPPI STATE UNIVERSITY
Authorized official
MRS. JANIE CIRLOT-NEW M.S., CCC/SLP (DIRECTOR SPEECH PATHOLOGIST AAC SPE)
(662) 325-1029
Entity
Organization
Contact information
Practice address
326 HARDY ROAD, MISSISSIPPI STATE, MS 39762
(662) 325-1028
(662) 325-0896
Mailing address
P.O. BOX 9736, MISSISSIPPI STATE, MS 39762
(662) 325-1028
(662) 325-0896
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
TA2922
MS
235Z00000X
Speech-Language Pathologist
S0478
MS
235Z00000X
Speech-Language Pathologist
Primary
S0482
MS
235Z00000X
Speech-Language Pathologist
S2375
MS
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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