| NPI | 1811408545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY B. CHANCE Assistant 601-519-5811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MS C0902) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2017-10-20 |