Organization
ESSENTIAL TOUCHTONES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA KILLEBREW PHD (OWNER)
(601) 750-6102
Entity
Organization
Contact information
Practice address
210 W. JACKSON STREET, RIDGELAND, MS 39157
(769) 231-9414
(601) 707-7291
Mailing address
210 W. JACKSON STREET, RIDGELAND, MS 39157
(769) 231-9414
(601) 707-7291
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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