| NPI | 1790802908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA M CAMBELL Office Manager 601-833-0895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C0969) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R672718) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |