LYDIA M. STATEN

JACKSON, MS
NPI1679788616
Former NameLYDIA ELEANOR MILLWOOD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: MS  C0715)
Enumeration Date2007-05-12
Last Update Date2012-05-25
Business Address
Mrs. LYDIA M. STATEN LCSW
1225 N WEST ST
JACKSON, MS 39202-2056
Phone number: 601-540-7105
Mailing Address
Mrs. LYDIA M. STATEN LCSW
1820 HIGHWAY 80 WEST
JACKSON, MS 39204-2056
Phone number: 601-540-7105