Individual
EMILY ILENE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
547 RIVER RD, HATTIESBURG, MS 39401-8527
(601) 466-9131
Mailing address
547 RIVER RD, HATTIESBURG, MS 39401-8527
(601) 466-9131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0344
MS
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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