Individual
MARY CECILLE GOYSICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4579 S EASON BLVD, TUPELO, MS 38801-6539
(662) 377-3161
(662) 377-2993
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33538
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117696
—
MS
Enumeration date
06/02/2006
Last updated
09/29/2015
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