| NPI | 1043734049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASAUNDRA L ROBERTS Sole Mbr 601-207-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-09 |