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Individual

D'ASYSA BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSW

Contact information

Practice address
5345 HIGHWAY 18 W, JACKSON, MS 39209-9421
(601) 927-0188
Mailing address
PO BOX 2305, CLINTON, MS 39060-2305
(601) 927-0188

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02551264
MS
Enumeration date
12/14/2022
Last updated
12/14/2022
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