| NPI | 1275282311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDRICK T HIBBLER Manager 601-408-0719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-07-28 |