Individual
AMANDA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7579 WISTERIA DR, OLIVE BRANCH, MS 38654-6982
(662) 874-6729
Mailing address
7579 WISTERIA DR, OLIVE BRANCH, MS 38654-6982
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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