| NPI | 1285478214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYNA LAQUISHA BURKS Owner/Senior Clinician 601-978-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QR0200X Clinic/Center, Radiology | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |