Provider Demographics
NPI:1942513221
Name:JOINER, AMBER SHANNON (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:SHANNON
Last Name:JOINER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2436 COUNTY ROAD 183 LOT 423
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-6956
Mailing Address - Country:US
Mailing Address - Phone:601-604-2136
Mailing Address - Fax:662-464-7700
Practice Address - Street 1:868 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:VAIDEN
Practice Address - State:MS
Practice Address - Zip Code:39176-5385
Practice Address - Country:US
Practice Address - Phone:662-464-7714
Practice Address - Fax:662-464-7700
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2555235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist