WILLIE EDWARD

MCCOMB, MS
NPI1629494463
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MS  0152)
Enumeration Date2014-03-17
Last Update Date2014-03-17
Business Address
-- WILLIE EDWARD
1701 WHITE ST
MCCOMB, MS 39648-2711
Phone number: 601-249-4228
Mailing Address
-- WILLIE EDWARD
1701 WHITE ST
MCCOMB, MS 39648-2711
Phone number: 601-249-4228
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