Rene F Dungan, SLP

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

NPI 1114192572 · NPPES record last updated Apr 28, 2008

Key facts

NPI
1114192572
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
S3033 (MS)
Practice address
1415 Broad Street
Columbia, MS 39429
Phone
(601) 736-8458
NPI assigned
Apr 28, 2008
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
S3033MSMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S3033 MS Yes

Addresses

Primary practice location

1415 Broad Street
Columbia, MS 39429

Mailing address

1415 Broad Street
Columbia, MS 39429
Phone (601) 736-8458

Other providers in Columbia, MS

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

Sources for this page

Verify at the official NPI Registry.