Leah Cori Gregory-Johnson, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Ruleville, MS

NPI 1003280702 · NPPES record last updated Nov 18, 2015

Key facts

NPI
1003280702
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
S4044 (MS)
Practice address
800 Stansel Dr
Ruleville, MS 38771-3320
Phone
(662) 756-4361
NPI assigned
Nov 18, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
S4044MSMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S4044 MS Yes

Addresses

Primary practice location

800 Stansel Dr
Ruleville, MS 38771-3320

Mailing address

800 Stansel Dr
Ruleville, MS 38771-3320

Other providers in Ruleville, MS

All providers in Ruleville, MS · Speech-Language Pathologist in Mississippi

Sources for this page

Verify at the official NPI Registry.