Individual
LAUREN SHORT ERP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4210 LINCOLN RD, HATTIESBURG, MS 39402-3093
(601) 261-3500
Mailing address
25 CIRCLE DR SE, MAGEE, MS 39111-4301
(985) 259-1473
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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