Individual
JACQUELINE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2100 EAST CHAMBERS STREET, BOONEVILLE, MS 38829
(662) 728-3174
Mailing address
PO BOX 839, CORINTH, MS 38835-0839
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0491
MS
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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