| NPI | 1194607416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH NOSEN Owner 601-277-2656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-08-04 |