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1376894212
CICELY C. TARAVELLA
JACKSON, MS
NPI
1376894212
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MS 52903)
Enumeration Date
2012-10-01
Last Update Date
2012-10-01
Business Address
-- CICELY C. TARAVELLA Ph.D.
1500 E WOODROW WILSON AVE TRP/MENTAL HEALTH (116A2)
JACKSON, MS 39216-5116
Phone number: 601-362-4471
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Mailing Address
-- CICELY C. TARAVELLA Ph.D.
1500 E WOODROW WILSON AVE TRP/MENTAL HEALTH (116A2)
JACKSON, MS 39216-5116
Phone number: 601-362-4471
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