Individual
KATHLEEN S PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
1119 1ST AVE NE, MAGEE, MS 39111-3111
(601) 466-8141
Mailing address
PO BOX 215, MAGEE, MS 39111-0215
(601) 466-8141
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33-514
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000188309
ANTHEM BLUE CROSS
IN
05
—
200226850
—
IN
01
—
326003
VALUE OPTIONS
IN
01
—
343411
MHN
IN
Enumeration date
12/29/2005
Last updated
08/26/2016
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