| NPI | 1760716385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER J WILKES Therapist 601-545-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS c4945) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |