Mary Catherine Ruscoe, CCC-SLP

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

NPI 1710499447 · NPPES record last updated Nov 3, 2017

Key facts

NPI
1710499447
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
S3370 (MS)
Practice address
201 Baker Blvd
Leland, MS 38756-3401
Phone
(662) 686-4121
Fax
(662) 686-4770
NPI assigned
Nov 3, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
S3370MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksdale Speech and Hearing Center Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S3370 MS Yes

Addresses

Primary practice location

201 Baker Blvd
Leland, MS 38756-3401

Mailing address

201 Baker Blvd
Leland, MS 38756-3401
Phone (662) 686-4121

Other providers in Leland, MS

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

Sources for this page

Verify at the official NPI Registry.