1386809606 NPI number — MRS. SHIRLEY ARNON HANDFORD M.S., CCC-SLP

Table of content: MRS. SHIRLEY ARNON HANDFORD M.S., CCC-SLP (NPI 1386809606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386809606 NPI number — MRS. SHIRLEY ARNON HANDFORD M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANDFORD
Provider First Name:
SHIRLEY
Provider Middle Name:
ARNON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WILLIAMS
Provider Other First Name:
SHIRLEY
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386809606
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
705 OLD CANTON RD
Provider Second Line Business Mailing Address:
P. O. BOX 1043
Provider Business Mailing Address City Name:
CARTHAGE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39051-4081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-267-6819
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 OLD CANTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39051-4081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-267-6819
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  S1193 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 09822099 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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