| NPI | 1689684102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA G CRUSO Office Manager 228-832-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MS 2190) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |