| NPI | 1023361888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRA PETERSON Executive Director 601-336-6847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 1542) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |