Individual
KATHERINE DALSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43 DR MARTIN LUTHER KING JR DR, MACON, MS 39341-2734
(662) 726-5042
(662) 726-5009
Mailing address
1032 STATE HWY 50 W, WEST POINT, MS 39773
(662) 524-4347
(662) 524-4364
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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