Organization
FOX & VINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY KEITH LMFT (OWNER)
(601) 436-0159
Entity
Organization
Contact information
Practice address
1501 ADELINE ST STE 2, HATTIESBURG, MS 39401-6264
(601) 255-8238
Mailing address
413 MAMIE ST, HATTIESBURG, MS 39401-5041
(601) 436-0159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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