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136 Honeysuckle Ln Vicksburg MS 39183-3454 | |
| (601) 826-9947 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 136 Honeysuckle Ln, Vicksburg, Mississippi |
| Authorized Official Name and Position | Miracle Mitchell (CEO) |
| Authorized Official Contact | 6018269947 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
316 Northridge Dr Vicksburg MS 39180-8394 Ph: (601) 826-9947 | 136 Honeysuckle Ln Vicksburg MS 39183-3454 Ph: (601) 826-9947 |
| NPI Number | 1619467735 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 05/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619467735 | NPI | - | NPPES |
| 08532364 | Other | MS | MIRACLE PAIGE |
| 1730586173 | Other | MS | MIRACLE MITCHELL |
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