| Wyatt & Jackson Center For Change, Llc | |
|
2637 Ridgewood Road Suite 100 Jackson MS 39216 | |
| (601) 981-8846 | |
| (601) 981-8873 |
| Full Name | Wyatt & Jackson Center For Change, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2637 Ridgewood Road Suite 100, Jackson, Mississippi |
| Authorized Official Name and Position | Mollie L. Wyatt (OWNER) |
| Authorized Official Contact | 6019818846 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyatt & Jackson Center For Change, Llc 2637 Ridgewood Rd Ste 100 Jackson MS 39216-4922 Ph: (601) 981-8846 | Wyatt & Jackson Center For Change, Llc 2637 Ridgewood Road Suite 100 Jackson MS 39216 Ph: (601) 981-8846 |
| NPI Number | 1801316807 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801316807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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