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Organization

KATHLEEN PATTERSON, PHD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN PATTERSON PHD (CLINICAL PSYCHOLOGIST/OWNER)
(601) 466-8141
Entity
Organization

Contact information

Practice address
1119 1ST AVE NE, MAGEE, MS 39111-3111
(601) 466-8141
Mailing address
PO BOX 215, MAGEE, MS 39111-0215
(601) 466-8141

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33-514
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
501719
MEDICARE PTAN
MS
Enumeration date
07/18/2016
Last updated
09/06/2016
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