| NPI | 1851700249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRA JOHNSON Clinical Director 601-982-0948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C6696) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2015-05-01 |