Individual
MR. CHRISTOPHER SHAN COTHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, LMFT
Contact information
Practice address
1108 PONDEROSA DR, TERRY, MS 39170-9416
(601) 373-9156
Mailing address
1108 PONDEROSA DR, TERRY, MS 39170-9416
(601) 373-9156
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
570
MS
106H00000X
Marriage & Family Therapist
T0137
MS
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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