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1386904803
STEPHANIE MACHELLE DOUGLASS
OLIVE BRANCH, MS
NPI
1386904803
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MS R863198)
Enumeration Date
2012-05-17
Last Update Date
2020-09-28
Business Address
STEPHANIE MACHELLE DOUGLASS PMHNP-BC
5600 GOODMAN RD STE B
OLIVE BRANCH, MS 38654-7002
Phone number: 662-890-7010
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Mailing Address
STEPHANIE MACHELLE DOUGLASS PMHNP-BC
5600 GOODMAN RD STE B
OLIVE BRANCH, MS 38654-7002
Phone number: 662-890-7010
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