| NPI | 1215523568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA MEADOWS Licensed Clinical Psychologist 601-319-3179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-20 |
| Last Update Date | 2020-12-20 |