Tclc Ms Behavioral Clinic | |
357 Towne Center Blvd Suite 400 Ridgeland MS 39157-4870 | |
(601) 899-5900 | |
Not Available |
Full Name | Tclc Ms Behavioral Clinic |
---|---|
Speciality | Psychologist |
Location | 357 Towne Center Blvd, Ridgeland, Mississippi |
Authorized Official Name and Position | Kimberly P Ray (PSYCHOLOGIST) |
Authorized Official Contact | 6018995900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tclc Ms Behavioral Clinic 357 Towne Center Blvd Suite 400 Ridgeland MS 39157-4870 Ph: (601) 899-5900 | Tclc Ms Behavioral Clinic 357 Towne Center Blvd Suite 400 Ridgeland MS 39157-4870 Ph: (601) 899-5900 |
NPI Number | 1801078415 |
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Provider Enumeration Date | 12/05/2007 |
Last Update Date | 12/05/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801078415 | NPI | - | NPPES |
36618 | Other | MS | PSYCHOLOGIST |
00119527 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (Mississippi) | Primary |
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