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Individual

CONNIE BIENVENU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 544-4641
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(604) 705-1952

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M8412
MS

Other

Enumeration date
06/04/2021
Last updated
06/04/2021
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