| NPI | 1023233749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHAN K. GUPTA Physician 601-957-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MS 12941) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2014-08-27 |