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Organization
BUTTERFLY AFFECT
Active
Organization
BUTTERFLY AFFECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GREEN (MEMBER)
(769) 226-6232
Entity
Organization
Contact information
Practice address
4915 I 55 N FRONTAGE RD STE C 305, JACKSON, MS 39205
(769) 226-6232
Mailing address
PO BOX 59053, JACKSON, MS 39284-9053
(769) 226-6232
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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