Provider Demographics
NPI:1134940588
Name:PAYTON, MARVA (SLPD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARVA
Middle Name:
Last Name:PAYTON
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 OLD WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-9809
Mailing Address - Country:US
Mailing Address - Phone:228-327-6658
Mailing Address - Fax:
Practice Address - Street 1:8900 OLD WALNUT RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-9809
Practice Address - Country:US
Practice Address - Phone:228-327-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-4426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist