Individual
KRISTINE WAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
623 E COURT ST STE A, JACKSON, MS 39201-5004
(410) 336-9303
Mailing address
623 E COURT ST STE A, JACKSON, MS 39201-5004
(410) 336-9303
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50078437
DC
Other
Enumeration date
01/14/2014
Last updated
01/14/2014
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