Individual
TRALICIA ANNREELL WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 S PEARSON RD, PEARL, MS 39208-5635
(769) 216-2466
Mailing address
5640 KEELE ST APT C21, JACKSON, MS 39206-3687
(888) 320-3222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-450498
MS
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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