| NPI | 1386147874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA CARROLL Sect 228-436-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: MS 10158) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-12 |