| NPI | 1508110917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SIGREST Member Manager 601-398-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C5370) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS LPC 0557) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-16 |