Individual
ABIGAIL DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 COLLEGE DR, HATTIESBURG, MS 39406-0002
(601) 266-1000
Mailing address
202 SOUTHAMPTON RD, HATTIESBURG, MS 39401-7069
(504) 296-5514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W251696135
AETNA
LA
Enumeration date
04/06/2022
Last updated
04/06/2022
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