Individual
MS. DESARAE SWILLEY RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
124 KIRKWOOD ST, PICAYUNE, MS 39466-3866
(601) 799-9500
(855) 675-8575
Mailing address
PO BOX 1111, PICAYUNE, MS 39466-1111
(601) 799-9500
(855) 675-8575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6956
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00802501
—
MS
Enumeration date
10/18/2012
Last updated
07/07/2022
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