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514 Campbell St Winona MS 38967-2519 | |
(601) 213-0896 | |
(601) 213-0973 |
Full Name | |
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Speciality | Counselor |
Location | 514 Campbell St, Winona, Mississippi |
Authorized Official Name and Position | Olevia Williams (PRESIDENT) |
Authorized Official Contact | 6012130896 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1478 Kristen Dr Jackson MS 39211-2115 Ph: (601) 213-0896 | 514 Campbell St Winona MS 38967-2519 Ph: (601) 213-0896 |
NPI Number | 1578939260 |
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Provider Enumeration Date | 08/17/2015 |
Last Update Date | 08/17/2015 |
Identifier | Type | State | Issuer |
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1578939260 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | M7245 (Mississippi) | Primary |