| Terral Latady, | |
| 
					1403 Lake Ave, Pascagoula, MS 39567-1626  | |
| (228) 219-4793 | |
| Not Available | 
| Full Name | Terral Latady | 
|---|---|
| Gender | Female | 
| Speciality | Speech-language Pathologist | 
| Location | 1403 Lake Ave, Pascagoula, Mississippi | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1174047302 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 14229602 (Mississippi) | Primary | 
| Provider Name | Speakeasy Clinic | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1649933250 PECOS PAC ID: 5092105858 Enrollment ID: O20211209001799  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Terral Latady, 1403 Lake Ave, Pascagoula, MS 39567-1626 Ph: (228) 219-4793  | Terral Latady, 1403 Lake Ave, Pascagoula, MS 39567-1626 Ph: (228) 219-4793  | 
Lakendra Brewer,  Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4403 Hospital St, Pascagoula, MS 39581 Phone: 228-762-8960 Fax: 228-769-1810  | |
Pamela Loper,  Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4403 Hospital St, Pascagoula, MS 39581 Phone: 228-162-8960 Fax: 662-620-9890  | |
Shelby Alexis Parker, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2809 Denny Ave, Pascagoula, MS 39581 Phone: 228-809-5000  | |
Sandi Horn, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3452 Pascagoula St, Pascagoula, MS 39567 Phone: 228-696-7088  | |
Mrs. Deanna H. Gray,  Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1623 Gallery St, Pascagoula, MS 39581 Phone: 228-235-1335  | |
Sharay T North,  Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3452 Pascagoula St Ste 2, Pascagoula, MS 39567 Phone: 228-249-9449  |