| NPI | 1407284615 |
|---|---|
| Doing Business As | MICHELLE JOHNSON |
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOHNSON Therapist 601-218-7041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |