Organization
HOLISTIC PSYCHOLOGICAL CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY LICHTE-MADAKASIRA PHD, LPC, LMFT, RYT (OWNER/PRESIDENT)
(601) 664-1001
Entity
Organization
Contact information
Practice address
2540 FLOWOOD DR, SUITE E, FLOWOOD, MS 39232-9362
(601) 664-1001
Mailing address
2540 FLOWOOD DR, SUITE E, FLOWOOD, MS 39232-9362
(601) 664-1001
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
0799
MS
Other
Enumeration date
04/08/2014
Last updated
04/17/2014
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