Individual
KELLY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCCSS
Contact information
Practice address
110 PATTON AVE, HATTIESBURG, MS 39401-6155
(601) 582-1111
(601) 450-0765
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3440
MS
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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