Individual
JENNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 MELISSA LOOP, PETAL, MS 39465-6303
(601) 270-3062
Mailing address
30 MELISSA LOOP, PETAL, MS 39465-6303
(601) 270-3062
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S5184
MS
235Z00000X
Speech-Language Pathologist
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Other
Enumeration date
02/16/2012
Last updated
05/19/2025
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