Individual
TIJUANA SIMELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., MHA
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
Mailing address
510 BEECHWOOD CIR, HOUSE #56, CORINTH, MS 38834-6937
(662) 750-4861
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
734965000
—
TN
Enumeration date
09/28/2006
Last updated
11/29/2016
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