Organization
SOULSHINE COUNSELING AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELIZABETH FOX (OWNER)
(662) 470-5433
Entity
Organization
Contact information
Practice address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378
Mailing address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2143
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05455768
—
MS
Enumeration date
02/26/2018
Last updated
09/07/2022
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