Individual
MS. VICKI CLARK MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ALL AMERICAN DRIVE, UNIVERSITY, MS 38677-1848
(662) 915-3789
(662) 915-7831
Mailing address
P.O. BOX 1848, ALL AMERICAN DRIVE, UNIVERSITY, MS 38677-1848
(662) 915-3789
(662) 915-7831
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0722
MS
106H00000X
Marriage & Family Therapist
T0357
MS
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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