Provider Demographics
NPI:1255023057
Name:RANSOM, KELSEY RONESIA
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:RONESIA
Last Name:RANSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:MS
Mailing Address - Zip Code:39071-9758
Mailing Address - Country:US
Mailing Address - Phone:601-506-2684
Mailing Address - Fax:
Practice Address - Street 1:207 W JACKSON ST STE 2
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2355
Practice Address - Country:US
Practice Address - Phone:601-362-0859
Practice Address - Fax:601-362-0870
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-5047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist