| NPI | 1497331508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BAKER SHERIDAN Owner 601-336-9131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2024-12-13 |