| NPI | 1083098495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY MICHELLE SPOTTS Owner 228-547-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 54965) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |