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Individual

MAKENZIE JEWEL COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P-LPC

Contact information

Practice address
1630 GOODMAN RD E STE 5, SOUTHAVEN, MS 38671-9556
(901) 647-9167
Mailing address
6584 LOVE RD, HERNANDO, MS 38632-8831
(901) 870-2223

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
P-1293
MS
101YP2500X
Professional Counselor
Primary
P-1293
MS

Other

Enumeration date
01/25/2025
Last updated
01/30/2025
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