Provider Demographics
NPI:1487806899
Name:DUKE, JOSEPHINE PILLOW (MS,CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:JOSEPHINE
Middle Name:PILLOW
Last Name:DUKE
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4611
Mailing Address - Country:US
Mailing Address - Phone:601-815-3049
Mailing Address - Fax:601-984-4138
Practice Address - Street 1:777 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4611
Practice Address - Country:US
Practice Address - Phone:601-815-3049
Practice Address - Fax:601-984-4138
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS1190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist