Individual
MILLICENT MCALILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4381 S EASON BLVD, SUITE 301, TUPELO, MS 38801-6583
(662) 377-6610
(662) 377-6614
Mailing address
4381 S EASON BLVD, SUITE 301, TUPELO, MS 38801-6583
(662) 377-6610
(662) 377-6614
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6775
MS
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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