| NPI | 1912452095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDRA WILSON Owner 601-214-7464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| 251S00000X | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2020-11-13 |