Mary Carlisle, SLP
Individual provider Active NPI Speech-Language Pathologist · Amory, MS
NPI 1760930804 · NPPES record last updated Sep 19, 2016
Key facts
- NPI
- 1760930804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SO806 (MS)
- Practice address
- 404 Lynnfield Dr
Amory, MS 38821-1208 - Phone
- (662) 369-5017
- NPI assigned
- Sep 19, 2016
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SO806 | MS | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SO806 | MS | Yes |
Addresses
Primary practice location
404 Lynnfield Dr
Amory, MS 38821-1208
Mailing address
404 Lynnfield Dr
Amory, MS 38821-1208
Phone (662) 369-5017
Other providers in Amory, MS
- Emily Ann Brown
- Raphael A Buckle
- Amy H Burrell
- Alicia Lauren Calhoun
- Caretime Medical Clinic, LLC
- Thomas Irby Carroll Jr.
- Carson Natural Health Center Inc
- Hayley Caughman
- James P Chaney
- Vern M Christensen
All providers in Amory, 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 Sep 19, 2016. 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.