Individual
MRS. TISHOUNNA KNOX SULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2260 MEAGAN DR, BYRAM, MS 39272-5676
(769) 216-0815
(601) 510-9049
Mailing address
2260 MEAGAN DR, BYRAM, MS 39272-5676
(769) 216-0815
(601) 510-9049
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6449
MS
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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