Organization
CHANGE HAPPENS COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TISSAN JACKSON (OWNER)
(601) 316-0951
Entity
Organization
Contact information
Practice address
110 CYPRESS RD, BYRAM, MS 39272-6046
(601) 316-0951
Mailing address
110 CYPRESS RD, BYRAM, MS 39272-6046
(601) 316-0951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M7339
MS
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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