| NPI | 1497156384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATORIA MILLER Biller/Credential Specialist 601-321-2497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 2054) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |