| Will's Way, Llc | |
|
604 Adeline St Suite B Hattiesburg MS 39401-3842 | |
| (601) 466-9190 | |
| (186) 662-5055 |
| Full Name | Will's Way, Llc |
|---|---|
| Speciality | Psychologist - School |
| Location | 604 Adeline St, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Dannell Speights Roberts (CO-OWNER PROGRAM DIRECTOR) |
| Authorized Official Contact | 6014669190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Will's Way, Llc Po Box 15955 Hattiesburg MS 39404-5955 Ph: (601) 466-9190 | Will's Way, Llc 604 Adeline St Suite B Hattiesburg MS 39401-3842 Ph: (601) 466-9190 |
| NPI Number | 1063795870 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 09/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063795870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | 47821 (Mississippi) | Primary |
| 103TS0200X | Psychologist - School | 204130 (Mississippi) | Secondary |
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