Individual
STEPHANIE KAY MCINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1395
Mailing address
124 GREENFIELD LN, PEARL, MS 39208-9462
(601) 362-4471
(601) 364-1395
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M2951
MS
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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