| NPI | 1720539315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN STONE Director, Business Management 228-331-3310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MS 55 988) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |