Individual
DR. ANDRES G VIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
2500 N STATE ST, DEPT OF PSYCHIATRY, JACKSON, MS 39216-4500
(601) 984-5855
(601) 984-5857
Mailing address
2500 N STATE ST, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS 39216-4500
(601) 984-5855
(601) 984-5857
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
52908
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06073391
—
MS
Enumeration date
10/18/2012
Last updated
01/29/2013
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