Individual
PAMELA J PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHT
Contact information
Practice address
20 CALVIN JOHNSON DR, STATE LINE, MS 39362-3901
(601) 705-1901
Mailing address
20 CALVIN JOHNSON DR, STATE LINE, MS 39362-3901
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CH1796
MS
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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