Organization
EVERGREEN THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LAUREN ALEXANDER (COUNSELOR/OWNER)
(601) 408-5946
Entity
Organization
Contact information
Practice address
105 N 40TH AVE, HATTIESBURG, MS 39401-6606
(769) 390-7929
Mailing address
103 FOX TER, HATTIESBURG, MS 39402-1813
(601) 408-5946
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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