| NPI | 1790982205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAY ANGELL NIELSEN Vice President 601-750-7759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C5559) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-08-22 |