BLUE HERON SPEECH THERAPY PLLC NPI 1962329789

NPI Information

  • NPI: 1962329789
  • Provider Name: BLUE HERON SPEECH THERAPY, PLLC
  • Classification: Clinic/Center - 261QR0400X
  • Specialization: Rehabilitation
  • Entity Type: Organization
  • Address: 1207 CHEROKEE ST
    PASCAGOULA, MS
    ZIP 39581
  • Phone: (251) 521-1389

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NPI Details

BLUE HERON SPEECH THERAPY, PLLC is a rehabilitation clinic center in Pascagoula, MS. BLUE HERON SPEECH THERAPY, PLLC NPI is 1962329789. The provider is registered as an organization entity type.

The provider's business location address is:

1207 CHEROKEE ST
PASCAGOULA, MS
ZIP 39581-403
Phone: (251) 521-1389

The provider's authorized official is Kendall Davis .
The authorized official title is Speech Pathologist and has the following contact phone number (228) 224-9359.

The enumeration date for this NPI number is 7/2/2026 and was last updated on 7/2/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0400XClinic/CenterRehabilitationYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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