| NPI | 1598933616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE PATRICIA KELLY Owner 601-453-5393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MS ms11556) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2013-06-19 |