Individual
RAEVIN ASHLEY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 N MAIN ST FL 3, HATTIESBURG, MS 39401-3582
(601) 699-4080
Mailing address
29 PARK PL APT 1417, HATTIESBURG, MS 39402-5902
(601) 433-0802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C12013
MS
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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