Individual
HART KATHERINE WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP, LPC
Contact information
Practice address
1855 LAKELAND DR, SUITE P-121, JACKSON, MS 39216-4913
(601) 366-4696
Mailing address
1855 LAKELAND DR, SUITE P-121, JACKSON, MS 39216-4913
(601) 366-4696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1360
MS
106H00000X
Marriage & Family Therapist
T0434
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R883581
MS
Other
Enumeration date
05/14/2010
Last updated
09/19/2012
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