Kelli Anne Cruthirds, SLP
Individual provider Active NPI Speech-Language Pathologist · Wiggins, MS
NPI 1104667112 · NPPES record last updated Jun 4, 2024
Key facts
- NPI
- 1104667112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- S-5090 (MS)
- Practice address
- 1601 Central Ave W
Wiggins, MS 39577-2401 - Phone
- (601) 716-3196
- Fax
- (601) 974-9919
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-5090 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Physical Therapy Clinic, Inc. | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
1620 Highway 11 N
Ste C
Picayune, MS 39466
Phone (769) 242-2626
1601 Central Ave W
Wiggins, MS 39577
Phone (601) 716-3196
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S-5090 | MS | Yes |
Addresses
Primary practice location
1601 Central Ave W
Wiggins, MS 39577-2401
Mailing address
1620 Highway 11 N Ste C
Picayune, MS 39466-2070
Phone (769) 242-2626
Other practice location 1
1620 Highway 11 N Ste C
Picayune, MS 39466-2070
Phone (769) 242-2626
Other providers in Wiggins, MS
- Christopher Collins
- Ray L Cooley
- Cornerstone Chiropractic PLLC
- Erin Couey
- Rebecca Cooley Courtney
- Marly Jill Davis
- Dental Group of Wiggins
- Donald Robert Doran Jr.
- Drayer Physical Therapy Institute LLC
- Drayer Physical Therapy Mississippi LLC
All providers in Wiggins, 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 Jun 4, 2024. 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.