Individual
MRS. AMY LEE SHUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2240 WESTBROOK RD, JACKSON, MS 39211-4900
(601) 957-7373
(601) 957-7372
Mailing address
115 STILLHOUSE CREEK DR, MADISON, MS 39110-6943
(601) 291-1010
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C2868
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62209
—
MS
Enumeration date
03/29/2011
Last updated
03/29/2011
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