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Organization

PRIMARY AND BEHAVIORAL HEALTHCARE SERVICES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHAMECA LEONORA HUDSON FNP, DNP-BC, PMHNP-B (CEO)
(769) 572-4009
Entity
Organization

Contact information

Practice address
717 E FORTIFICATION ST, JACKSON, MS 39202-2402
(769) 572-4009
(769) 572-4021
Mailing address
717 E FORTIFICATION ST, JACKSON, MS 39202-2402
(769) 572-4009
(769) 572-4021

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
07/08/2019
Last updated
10/28/2019
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