| Montera Health Mississippi Llc | |
|
270 Trace Colony Park Dr Ste B Ridgeland MS 39157-8810 | |
| (865) 680-1516 | |
| Not Available |
| Full Name | Montera Health Mississippi Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 270 Trace Colony Park Dr Ste B, Ridgeland, Mississippi |
| Authorized Official Name and Position | Qingqing Mao (ADMIN) |
| Authorized Official Contact | 4158051725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montera Health Mississippi Llc 270 Trace Colony Park Dr Ste B Ridgeland MS 39157-8810 Ph: (865) 680-1516 | Montera Health Mississippi Llc 270 Trace Colony Park Dr Ste B Ridgeland MS 39157-8810 Ph: (865) 680-1516 |
| NPI Number | 1518614106 |
|---|---|
| Provider Enumeration Date | 03/03/2022 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518614106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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