Individual
JOHN JEFFERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
217 COURT STREET, WEST POINT, MS 39773
(662) 494-7060
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-3918
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700894730
MENTAL HEALTH COUNSELOR
MS
Enumeration date
04/04/2023
Last updated
04/04/2023
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