Individual
RUSSELL CHUMLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4579 SOUTH EASON BOULEVARD, TUPELO, MS 38801
(662) 377-3115
Mailing address
PO BOX 4581, TUPELO, MS 38803-4581
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0481
MS
106H00000X
Marriage & Family Therapist
Primary
T0358
MS
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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