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1568722874
KELLY WAYNE FERGUSON
OXFORD, MS
NPI
1568722874
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: FL MT0897)
Enumeration Date
2012-05-21
Last Update Date
2013-09-06
Business Address
Mr. KELLY WAYNE FERGUSON MA, LMFT
1916 UNIVERSITY AVE
OXFORD, MS 38655-4114
Phone number: 662-281-1306
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Mailing Address
Mr. KELLY WAYNE FERGUSON MA, LMFT
60 DOGWOOD CV
PONTOTOC, MS 38863-7627
Phone number: 386-214-4351
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