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
| License | State | Type | Specialty |
|---|---|---|---|
| S4044 | MS | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Ruleville, MS · Speech-Language Pathologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.