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Individual

TABITHA BURKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PCMHT

Contact information

Practice address
1701 WHITE ST, MCCOMB, MS 39648-2711
(601) 249-4228
(601) 249-4244
Mailing address
1214 14TH ST, MCCOMB, MS 39648-5234
(601) 249-4228
(601) 249-4244

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/03/2013
Last updated
09/03/2013
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