| NPI | 1760686299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSCOE LORMER DOUGLAS Clinical Psychologist 601-483-8370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 139) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |