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Individual

CORBY W. PATHANOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4500 I 55 N STE 216, JACKSON, MS 39211-5931
(601) 859-8371
Mailing address
761 RICE RD APT 403, RIDGELAND, MS 39157-1089
(850) 512-6788

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1394
MS

Other

Enumeration date
03/12/2012
Last updated
07/11/2023
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