Organization
SOUTHERN SMALL TALK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL W ANDERSON M.S., CCC/SLP (SPEECH-LANGUAGE PATHOLOGIST/CEO)
(601) 527-5969
Entity
Organization
Contact information
Practice address
849 WILLOW GRANDE CIR, BRANDON, MS 39047-8352
(601) 527-5969
Mailing address
849 WILLOW GRANDE CIR, BRANDON, MS 39047-8352
(601) 527-5969
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3417
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00726008
—
MS
Enumeration date
09/04/2013
Last updated
09/04/2013
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