Individual
MRS. HOLLY ANN MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
4214 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-5975
(228) 218-3362
(228) 872-9370
Mailing address
20250 WHITE RD, VANCLEAVE, MS 39565-6430
(228) 218-3362
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S1189
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200002991
—
MS
Enumeration date
04/23/2007
Last updated
07/06/2023
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