Individual
ERIC SUDDEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
304 ENTERPRISE DR, OXFORD, MS 38655-2762
(662) 371-1711
Mailing address
4005 DAVIS DR, OXFORD, MS 38655-4279
(901) 607-3705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2201
MS
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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