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1861856841
LEE-KEETHIA TYANNE THOMPSON-PORTER
JACKSON, MS
NPI
1861856841
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MS CMHT2942)
Enumeration Date
2016-04-06
Last Update Date
2022-06-02
Business Address
Ms. LEE-KEETHIA TYANNE THOMPSON-PORTER CMHT
4780 I 55 N STE 105
JACKSON, MS 39211-5542
Phone number: 601-956-4816
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Mailing Address
Ms. LEE-KEETHIA TYANNE THOMPSON-PORTER CMHT
4780 I 55 N STE 105
JACKSON, MS 39211-5542
Phone number: 601-956-4816
Copy
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