Individual
KALEIGH COUNTISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1855 LAKELAND DR, R305, JACKSON, MS 39216-4913
(601) 982-5376
Mailing address
1855 LAKELAND DR, R305, JACKSON, MS 39216-4913
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2044
MS
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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