Individual
MYRTIS AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 NORTHRIDGE DR, GAUTIER, MS 39553-4924
(228) 437-5653
Mailing address
2600 NORTHRIDGE DR, GAUTIER, MS 39553-4924
(228) 437-5653
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0289
MS
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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