Upa Pllc Ped Psychology

NPI 1467505222 - Psychologist - 103TB0200X

NPI Details
NPI 1467505222
Enumeration Date 01/18/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name OWEN B OWEN
Position MANAGER
Phone (601) 984-5274
Fax
Practice Location
2500 N STATE ST
JACKSON MS, 39216-4500, US
Phone (601) 984-5274
Fax
Business Location
2500 N STATE ST
JACKSON MS, 39216-4500, US
Phone (601) 984-5274
Fax
Toxanomy
Taxonomy Code 103TB0200X
License State
License Number
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According to our database, Upa Pllc Ped Psychology NPI is 1467505222, taxonomy code is 103TB0200X Upa Pllc Ped Psychology physically located at 2500 N State St, Jackson MS, 39216-4500. NPI Number 1033115704 has the healthcare provider type.

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1467505222 NPI number is provided on an as is basis without warranty of any kind. 1467505222 is maintained by the National Plan & Provider Enumeration System. The contents of Upa Pllc Ped Psychology are for informational purposes only.