Individual
CORONDA WEATHERSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
(769) 251-5550
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
(769) 251-5550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1773
MS
Other
Enumeration date
03/08/2012
Last updated
02/11/2020
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