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Organization

MAGNOLIA BEHAVIORAL PSYCHOLOGY, PLLC

Active
Other names
Magnolia Behavioral Psychology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EVAN HENRY DART PH.D., LP (LICENSED PSYCHOLOGIST)
(985) 373-1497
Entity
Organization

Contact information

Practice address
6668 HWY 98, SUITE A, HATTIESBURG, MS 39402-9098
(601) 348-7792
Mailing address
6668 HWY 98, SUITE A, HATTIESBURG, MS 39402-9098

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
55978
MS

Other

Enumeration date
02/18/2016
Last updated
09/29/2016
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