Provider Demographics
NPI:1235894627
Name:VARIATION OF SPEECH
Entity Type:Organization
Organization Name:VARIATION OF SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARTON-MCGOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:601-507-0653
Mailing Address - Street 1:1508 HUNTLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6336
Mailing Address - Country:US
Mailing Address - Phone:601-507-0653
Mailing Address - Fax:601-790-7137
Practice Address - Street 1:1508 HUNTLEY BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6336
Practice Address - Country:US
Practice Address - Phone:601-507-0653
Practice Address - Fax:601-790-7137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty