Individual
MARY ELIZABETH PRESTAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
113A S DAVIS AVE, CLEVELAND, MS 38732-3447
(662) 843-9445
(662) 843-9447
Mailing address
113A S DAVIS AVE, CLEVELAND, MS 38732-3447
(662) 843-9445
(662) 843-9447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
942
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018205
—
MS
Enumeration date
12/31/2007
Last updated
01/11/2008
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