Individual
JENNIFER KNIGHT EMBREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 705-1923
Mailing address
PO BOX 1030, HATTIESBURG, MS 39403-1030
(601) 705-1923
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CH0770
MS
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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