Individual
SAMUEL MAISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MS
Other
Enumeration date
10/01/2025
Last updated
10/24/2025
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