| NPI | 1588905939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH M SHOEMAKER, PHD Principle 228-875-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MS 46-802) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 1728) |
| 103T00000X Psychologist (Licence: MS 53938) | |
| 106H00000X Marriage & Family Therapist (Licence: MS T0437) | |
| 101YP2500X Counselor, Professional (Licence: MS 1977) | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2016-01-05 |