Individual
GEORGIA VAN LEIJSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
599 HIGHLAND COLONY PKWY STE 110, RIDGELAND, MS 39157-6075
(601) 202-5980
Mailing address
4654 HICKORY RIDGE RD, JACKSON, MS 39211-5846
(601) 622-6277
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
2255A2300X
Athletic Trainer
AT715
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2015
Last updated
06/03/2024
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