Individual
MRS. SAMANTHA MAILE LORENZO WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
460 LEGACY BLVD, HATTIESBURG, MS 39402-5500
(808) 227-1114
Mailing address
460 LEGACY BLVD, HATTIESBURG, MS 39402-5500
(808) 227-1114
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3044-22
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
AD23-043W
MS
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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