Individual
CHARLES S. SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
(662) 453-6211
Mailing address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
(662) 453-6211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8110
MS
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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