Individual
ELIJAH MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
Mailing address
459 BUENA VISTA AVE, JACKSON, MS 39209-6406
(662) 588-2060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P-1488
MS
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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