Organization
KIDZ KONNECTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASYA JOY LOPEZ (ADMINISTRATOR)
(404) 279-0598
Entity
Organization
Contact information
Practice address
500 AVALON WAY, APT 313, BRANDON, MS 39047-7533
(404) 279-0598
Mailing address
2460 TERRY RD, SUITE 700, JACKSON, MS 39204-5767
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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