Organization · NPI-2

Becoming Undone Therapy Services LLC

Community/Behavioral Health · Hattiesburg, MS

NPI number1215705256
StatusActive
Last updated in NPPESDec 19, 2023

Details

NPI
1215705256
Entity type
Organization (NPI-2)
Legal business name
Becoming Undone Therapy Services LLC
Organization subpart
No
Enumeration date
Dec 19, 2023
Certification date
Dec 19, 2023
Last updated
Dec 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes

Practice location

4010 Oferral St Ste 209
Hattiesburg, MS 39402-1613

Phone 601-463-8418

Mailing address

4208 Highway 8 E
Okolona, MS 38860-9390

Authorized official

Shania Barr
Owner
6014472321

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