Individual
MRS. JAQUELINE TOLLESON CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC/MHSP
Contact information
Practice address
1045 CHURCH RD E STE 2, SOUTHAVEN, MS 38671-9702
(662) 235-9063
(662) 536-7439
Mailing address
1045 CHURCH RD E STE 2, SOUTHAVEN, MS 38671-9702
(662) 235-9063
(662) 536-7439
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1733
MS
Other
Enumeration date
10/25/2012
Last updated
02/12/2021
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