Individual
ROSCOE LORMER DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1207 WHITE OAK DR, MERIDIAN, MS 39305-1902
(601) 483-8370
(601) 482-4248
Mailing address
1207 WHITE OAK DR, MERIDIAN, MS 39305-1902
(601) 493-9370
(601) 482-4248
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10 139
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017960
—
MS
Enumeration date
05/10/2007
Last updated
07/08/2007
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