| NPI | 1649629304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH BISHOP Office Manager 601-781-8677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2022-07-21 |