Individual
MS. LEE-KEETHIA TYANNE THOMPSON-PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHT
Contact information
Practice address
4780 I 55 N STE 105, JACKSON, MS 39211-5542
(601) 956-4816
(601) 956-4817
Mailing address
4780 I 55 N STE 105, JACKSON, MS 39211-5542
(601) 956-4816
(601) 956-4817
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMHT2942
MS
Other
Enumeration date
04/06/2016
Last updated
06/02/2022
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