Organization
DEFINING WELLNESS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA MUKHERJEE (DIRECTOR OF REVENUE CYCLE)
(754) 261-8405
Entity
Organization
Contact information
Practice address
411 HANOVER CIR STE 100, RIDGELAND, MS 39157-8814
(855) 761-1582
(769) 241-2605
Mailing address
3949 HIGHWAY 43 N, BRANDON, MS 39047-7240
(754) 261-8405
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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