Individual
MARY FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378
Mailing address
1310 GOODMAN RD E, SOUTHAVEN, MS 38671-9542
(662) 470-5433
(501) 745-2378
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2143
MS
Other
Enumeration date
02/04/2015
Last updated
09/07/2022
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