| Speakeasy Clinic | |
|
3452 Pascagoula St Ste 2, Pascagoula, MS 39567-3203 | |
| (228) 219-4793 | |
| Not Available |
| Full Name | Speakeasy Clinic |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 3452 Pascagoula St Ste 2, Pascagoula, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649933250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Terral Latady |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1174047302 PECOS PAC ID: 6901296763 Enrollment ID: I20211209001939 |
| Provider Name | Sharay North |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1366105751 PECOS PAC ID: 9436541083 Enrollment ID: I20220322000046 |
| Mailing Address | Practice Location Address |
|---|---|
| Speakeasy Clinic 1403 Lake Ave, Pascagoula, MS 39567-1626 Ph: (228) 219-4793 | Speakeasy Clinic 3452 Pascagoula St Ste 2, Pascagoula, MS 39567-3203 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 | |
Terral Latady, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1403 Lake Ave, Pascagoula, MS 39567 Phone: 228-219-4793 | |
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: Medicare Enrolled 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 | |
Sharay T North, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3452 Pascagoula St Ste 2, Pascagoula, MS 39567 Phone: 228-249-9449 | |
Rebecca Varnadore, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 4211 Hospital St Ste 114, Pascagoula, MS 39581 Phone: 228-762-8960 Fax: 228-769-1810 |