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Behavioral Analyst

Southaven, Mississippi

Provider NPI: 1336471291

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 662-812-5833  Fax: 662-349-0709

Business Mailing Address:
Tel: 662-812-5833  Fax: 662-349-0709

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number


Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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