| NPI | 1528443975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATTIE ARMSTRONG Controller 601-899-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |