Individual
ROBERT ALLEN SHIVE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
141 TOWNSHIP AVE STE 303, RIDGELAND, MS 39157-8699
(601) 844-3884
Mailing address
4305 AUDUBON PARK LN, JACKSON, MS 39211-6141
(601) 906-3314
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3095
MS
Other
Enumeration date
07/14/2022
Last updated
03/15/2024
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