CODIE JACLYN GREEN

SUMRALL, MS
NPI1225769482
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: MS  S-4294)
Enumeration Date2022-06-20
Last Update Date2022-06-20
Business Address
CODIE JACLYN GREEN
668 OLD SALT RD
SUMRALL, MS 39482-4232
Phone number: 601-270-6968
Mailing Address
CODIE JACLYN GREEN
17 E CHERRY
SUMRALL, MS 39482-0400
Phone number:
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