| NPI | 1891136818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E WILKAITIS Owner 601-939-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 174-35) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |