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206 W Jackson St Ste 100 Ridgeland MS 39157-2310 | |
| (769) 300-1443 | |
| (769) 208-4477 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 206 W Jackson St Ste 100, Ridgeland, Mississippi |
| Authorized Official Name and Position | Dea Dixon Dean (OWNER/PRESIDENT) |
| Authorized Official Contact | 7693001443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
206 W Jackson St Ste 100 Ridgeland MS 39157-2310 Ph: (769) 300-1443 | 206 W Jackson St Ste 100 Ridgeland MS 39157-2310 Ph: (769) 300-1443 |
| NPI Number | 1902392574 |
|---|---|
| Provider Enumeration Date | 07/07/2018 |
| Last Update Date | 07/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902392574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1986 (Mississippi) | Primary |
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