| NPI | 1497200570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE LUSTER SINGLETON Administrator 601-434-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C5919) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |