Individual
JUDY M. HARVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
900 1ST AVE NE, MAGEE, MS 39111-3255
(601) 849-4221
(601) 849-7188
Mailing address
PO BOX 1160, MAGEE, MS 39111-1160
(601) 849-4221
(601) 849-7188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C4861
MS
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C4861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126306
—
MS
Enumeration date
08/30/2006
Last updated
01/15/2008
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