| NPI | 1912158668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ELIAS-HOOPER Owner 601-856-0582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 33543) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |