Individual
MARLA MCMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, PLPC
Contact information
Practice address
6858 SWINNEA RD BLDG 7, SOUTHAVEN, MS 38671-9493
(662) 536-6210
(662) 510-8820
Mailing address
3148 STONEHENGE DR, HERNANDO, MS 38632-7366
(901) 484-4256
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P-0326
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32-0124592
AETNA
—
Enumeration date
08/13/2022
Last updated
08/25/2022
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