| NPI | 1356157390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYL NICOLE BANKS Owner 601-668-7828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |