Individual
MRS. ELIZABETH LOVE MCGILLIVRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
356 E OXFORD ST, PONTOTOC, MS 38863-2314
(662) 296-1040
Mailing address
356 E OXFORD ST., PONTOTOC, MS 38863
(662) 296-1040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7370
MS
Other
Enumeration date
04/10/2013
Last updated
09/02/2014
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