Provider Demographics
NPI:1134443104
Name:COX, MISTY HOWINGTON (SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:HOWINGTON
Last Name:COX
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 DELAPERRIERE LOOP
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-7949
Mailing Address - Country:US
Mailing Address - Phone:706-207-1354
Mailing Address - Fax:
Practice Address - Street 1:470 DELAPERRIERE LOOP
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-7949
Practice Address - Country:US
Practice Address - Phone:706-207-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist