Individual
MRS. LISA A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
120 STREET A STE C, PICAYUNE, MS 39466-6303
(601) 569-5311
Mailing address
120 STREET A STE C, PICAYUNE, MS 39466-6303
(601) 569-5311
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/10/2016
Last updated
10/21/2019
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