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1740942184
PHYLLIS A BAILEY
SOUTHAVEN, MS
NPI
1740942184
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MS CA0232)
Enumeration Date
2021-10-13
Last Update Date
2021-10-13
Business Address
PHYLLIS A BAILEY MS. CAT
4744 WE ROSS PKWY APT 44-205
SOUTHAVEN, MS 38671-6386
Phone number: 901-287-1859
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Mailing Address
PHYLLIS A BAILEY MS. CAT
340 STATE LINE RD WEST
SOUTHAVEN, MS 38671
Phone number: 662-510-5387
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