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Individual

ROGER D. CORLEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P-LPC

Contact information

Practice address
745 AVIGNON DR STE C, RIDGELAND, MS 39157-5186
(601) 850-7047
Mailing address
517 HAZELTON DR, MADISON, MS 39110-7476
(731) 402-6650

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P-0774
MS

Other

Enumeration date
02/10/2022
Last updated
10/31/2023
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