Individual
MR. DANNY J STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4780 I 55 N STE 105, JACKSON, MS 39211-5542
(601) 956-4816
(601) 956-4817
Mailing address
4780 I 55 N STE 105, JACKSON, MS 39211-5542
(601) 956-4816
(601) 956-4817
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01670076
—
MS
Enumeration date
06/11/2021
Last updated
01/03/2022
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