Individual
SHAVONNE LYNETT THIGPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
156 HIGHWAY 51 N, BATESVILLE, MS 38606-2348
(662) 712-6257
Mailing address
860 E RIVER PL, JACKSON, MS 39202-3442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PH4955
MS
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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