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Individual

JEAN W WALRATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPO LMFT MED

Contact information

Practice address
600 HOGAN STREET, SUITE 2C, STARKVILLE, MS 39759-3376
(662) 323-8148
(662) 323-1516
Mailing address
600 HOGAN STREET, SUITE 2C, STARKVILLE, MS 39759-3376
(662) 323-8148
(662) 323-1516

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0801
MS
106H00000X
Marriage & Family Therapist
T0307
MS

Other

Enumeration date
12/04/2006
Last updated
09/11/2025
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