Individual
TAMELA MOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 JACKSONIAN PLZ STE 14131, JACKSON, MS 39211-5454
(769) 300-5340
Mailing address
PO BOX 14131, JACKSON, MS 39236-4131
(769) 300-5340
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
10/03/2025
Last updated
10/24/2025
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