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Organization

REMEDIAL SPECIALISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELIZABETH A. GOCHNOUR SLP (DIRECTOR)
(662) 473-0012
Entity
Organization

Contact information

Practice address
105 N COURT ST, WATER VALLEY, MS 38965-1806
(662) 473-0012
(662) 473-0013
Mailing address
PO BOX 594, WATER VALLEY, MS 38965-0594
(662) 473-0012
(662) 473-0013

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3049
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0786823
CIGNA PROVIDER I.D.
MS
01
V02064770
DISABILTY DETERM VENDOR #
MS
Enumeration date
01/23/2007
Last updated
08/22/2020
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