Individual
AERIELL B. TALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9318
Mailing address
241 NORTHWOOD FOREST RD, WEST POINT, MS 39773-9089
(662) 275-3803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/25/2021
Last updated
08/26/2021
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