Provider Demographics
NPI:1386809606
Name:HANDFORD, SHIRLEY ARNON (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:ARNON
Last Name:HANDFORD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:A
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:705 OLD CANTON RD
Mailing Address - Street 2:P. O. BOX 1043
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-4081
Mailing Address - Country:US
Mailing Address - Phone:601-267-6819
Mailing Address - Fax:
Practice Address - Street 1:705 OLD CANTON RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-4081
Practice Address - Country:US
Practice Address - Phone:601-267-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS1193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09822099Medicaid