| NPI | 1003172149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJUANZIE LUCIANNA ROSS-JOHNSON Speech Pathologist 601-750-3843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: MS S3090) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |