Individual
JUANTARIO BADON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCMHT
Contact information
Practice address
301 ROBB ST, SUMMIT, MS 39666-7053
(769) 217-2810
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6025
MS
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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