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1013149301
PHYLLIS A GRINSTEAD
HATTIESBURG, MS
NPI
1013149301
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MS 1824)
Enumeration Date
2009-08-20
Last Update Date
2009-08-20
Business Address
-- PHYLLIS A GRINSTEAD PCMHT
4001 MAMIE ST
HATTIESBURG, MS 39402
Phone number: 601-705-1901
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Mailing Address
-- PHYLLIS A GRINSTEAD PCMHT
4001 MAMIE ST
HATTIESBURG, MS 39402
Phone number: 601-705-1901
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