| NPI | 1952503286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON LORE DAVIS Administrator 601-853-2676 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2012-06-20 |