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Organization

REGION IV MHS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. IDA PATRICIA AKINES (PSR SUPERVISOR)
(662) 286-7084
Entity
Organization

Contact information

Practice address
601 FOOTE ST, CORINTH, MS 38834-4834
(662) 286-7084
(662) 286-2070
Mailing address
601 FOOTE ST, CORINTH, MS 38834-4834
(662) 286-7084
(662) 286-2070

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
02/10/2015
Last updated
02/10/2015
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