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Organization

WILL'S WAY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANNELL SPEIGHTS ROBERTS PH.D. (CO-OWNER PROGRAM DIRECTOR)
(601) 466-9190
Entity
Organization

Contact information

Practice address
604 ADELINE ST, SUITE B, HATTIESBURG, MS 39401-3842
(601) 466-9190
(186) 662-5055
Mailing address
PO BOX 15955, HATTIESBURG, MS 39404-5955
(601) 466-9190
(186) 662-5055

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
204130
MS
103TS0200X
School Psychologist
Primary
47821
MS

Other

Enumeration date
09/28/2011
Last updated
09/28/2011
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