Individual
TANYA LARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2627 RIDGEWOOD RD, STE 103, JACKSON, MS 39216-4904
(601) 942-1884
Mailing address
252 CALLAWAY CIR, BYRAM, MS 39272-4521
(601) 942-1884
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0442
MS
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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