| NPI | 1124471412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROANE THERELL HUNTER Counselor/ Family Therapist 601-790-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 1897) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MS 1830) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-09-27 |