Individual
CALLIE PHELPS WALDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 MILLBRANCH RD, 1200, HATTIESBURG, MS 39402-1670
(601) 255-5264
Mailing address
23 TRILLIUM, HATTIESBURG, MS 39402-5511
(817) 933-1421
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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