Individual
ALICE H EMANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
248 E CAPITOL ST, 840 TRUST MARK BLDG, JACKSON, MS 39201-2503
(800) 632-6074
(866) 341-7509
Mailing address
PO BOX 12976, JACKSON, MS 39236-2976
(601) 206-7770
(601) 206-9090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C0368
MS
1041C0700X
Clinical Social Worker
Primary
C0368
MS
Other
Enumeration date
06/29/2006
Last updated
08/13/2007
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