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Individual

OLIVIA HOGAN ISMAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
615 W PINE ST, HATTIESBURG, MS 39401-3835
(601) 336-9131
Mailing address
316 S 12TH AVE, HATTIESBURG, MS 39401-6233
(601) 218-8508

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C9099
MS

Other

Enumeration date
10/12/2021
Last updated
10/12/2021
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