Individual
PHYLLIS A GRINSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCMHT
Contact information
Practice address
4001 MAMIE ST, HATTIESBURG, MS 39402
(601) 705-1901
Mailing address
4001 MAMIE ST, HATTIESBURG, MS 39402
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1824
MS
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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