| NPI | 1275737959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D. HERZOG Clinical Psychologist 601-981-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 26348) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |