Individual
TABAN SALEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
241 SUNNYBROOK RD, RIDGELAND, MS 39157-2206
(769) 231-9414
Mailing address
3912 GREAVES ST, JACKSON, MS 39206-5711
(636) 544-4472
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
611103
MS
Other
Enumeration date
03/16/2022
Last updated
11/19/2024
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