| NPI | 1487950564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALYN DATZ Clinical Director/Owner 601-255-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2013-01-15 |