Individual
AMANDA BAGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(662) 443-1808
(662) 449-1811
Mailing address
PO BOX 839, CORINTH, MS 38835-0839
(662) 286-9883
(662) 286-9836
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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