Individual
TANEILL EVERETT BARBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4363 HENDERSON CIR, JACKSON, MS 39206-5926
(601) 383-2442
Mailing address
4363 HENDERSON CIRCLE, JACKSON, MS 39206
(601) 383-2442
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-2295
MS
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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