Provider Demographics
NPI:1902020001
Name:AMES, MARCI E (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:E
Last Name:AMES
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AMES RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71343-5201
Mailing Address - Country:US
Mailing Address - Phone:318-386-7214
Mailing Address - Fax:
Practice Address - Street 1:55 SGT PRENTISS DR
Practice Address - Street 2:SUITE 8
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4782
Practice Address - Country:US
Practice Address - Phone:601-446-8764
Practice Address - Fax:601-446-8745
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2962235Z00000X
LA6077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1431281Medicaid
MS04637243Medicaid