NPI | 1992290522 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLIE SWINDOL WEST Owner/Clinician 601-606-0561 |
Organization Subpart ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YP2500X Counselor Professional |
261QM0850X Clinic/Center Adult Mental Health (Licence: MS 2114) | |
261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: MS 2114) | |
Enumeration Date | 2018-06-26 |
Last Update Date | 2021-03-09 |