Individual
MR. MICHAEL PRESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
940 EBENEZER BLVD, MADISON, MS 39110-6002
(321) 480-5000
Mailing address
416 DECELLE ST, JACKSON, MS 39216-3103
(321) 480-5000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2198
MS
106H00000X
Marriage & Family Therapist
001182
NY
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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