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688 Pleasant Ridge Rd Sturgis MS 39769-6620 | |
(662) 328-4736 | |
Not Available |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 688 Pleasant Ridge Rd, Sturgis, Mississippi |
Authorized Official Name and Position | Gwendolyn Gray (CEO) |
Authorized Official Contact | 6623284736 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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688 Pleasant Ridge Rd Sturgis MS 39769-6620 Ph: (662) 328-4736 | 688 Pleasant Ridge Rd Sturgis MS 39769-6620 Ph: (662) 328-4736 |
NPI Number | 1427307057 |
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Provider Enumeration Date | 08/29/2012 |
Last Update Date | 08/29/2012 |
Identifier | Type | State | Issuer |
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1427307057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 130920217 (Mississippi) | Primary |