Provider Demographics
NPI:1003786112
Name:HERRINGTON, CAMRYN
Entity type:Individual
Prefix:
First Name:CAMRYN
Middle Name:
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAMRYN
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 MELISSA LOOP
Mailing Address - Street 2:
Mailing Address - City:PETAL
Mailing Address - State:MS
Mailing Address - Zip Code:39465-6303
Mailing Address - Country:US
Mailing Address - Phone:769-224-0683
Mailing Address - Fax:601-277-6453
Practice Address - Street 1:30 MELISSA LOOP
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-6303
Practice Address - Country:US
Practice Address - Phone:769-224-0683
Practice Address - Fax:601-277-6453
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-4953235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist