NPI | 1730663469 |
---|---|
Entity Type | Organization |
Authorized Contact | ALYSSA KILLEBREW Owner 601-750-6102 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2018-09-19 |
Last Update Date | 2018-09-19 |