| NPI | 1467793919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET ANGELYN LATTA Independent Contractor 601-209-6638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL S8760) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |