1417266503 NPI number — CHATTER BOX THERAPY SERVICES, PLLC

Table of content: DR. SARA JAYNE SUTTON DO (NPI 1477282887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417266503 NPI number — CHATTER BOX THERAPY SERVICES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHATTER BOX THERAPY SERVICES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417266503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5891 HIGHWAY 49
Provider Second Line Business Mailing Address:
SUITE 60-118
Provider Business Mailing Address City Name:
HATTIESBURG
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39402-2810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-818-0103
Provider Business Mailing Address Fax Number:
601-812-5424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5891 HIGHWAY 49
Provider Second Line Business Practice Location Address:
SUITE 60-118
Provider Business Practice Location Address City Name:
HATTIESBURG
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39402-2810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-818-0103
Provider Business Practice Location Address Fax Number:
601-812-5424
Provider Enumeration Date:
10/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
FRIED
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
ORGERON
Authorized Official Title or Position:
OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
601-818-0103

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  S3205 , 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)





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