| NPI | 1922492321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL WAYNE BRUNO Owner 601-746-5125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C8179) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-03-24 |