Jackson Family First
Psychologist, Clinical Child & Adolescent in Jackson, MS. Organization (NPI-2).
NPI number1376094532
StatusActive
Last updated in NPPESOct 21, 2016
Details
- NPI
- 1376094532
- Entity type
- Organization (NPI-2)
- Legal business name
- Jackson Family First
- Organization subpart
- No
- Enumeration date
- Oct 21, 2016
- Last updated
- Oct 21, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | – | – | Yes |
Practice location
125 Cedarwood DrJackson, MS 39212-2208
Phone 601-503-4563
Mailing address
125 Cedarwood DrJackson, MS 39212-2208
Phone 601-503-4563
Authorized official
Chanda M. Rhodes
Owner
6015034563
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