Individual
MS. LEILANI LANI GREENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5808
(601) 815-4710
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5808
(601) 815-4710
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
46747
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03132221
—
MS
01
—
302I623569
PTAN
MS
Enumeration date
07/14/2006
Last updated
09/21/2012
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