Individual
MR. TIMOTHY AARON STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHT
Contact information
Practice address
1019 CARROLL DR, HAZLEHURST, MS 39083-2036
(601) 894-2018
Mailing address
1019 CARROLL DR, HAZLEHURST, MS 39083-2036
(601) 894-2018
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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