Individual
KATHY L ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15012 LEMOYNE BLVD, BILOXI, MS 39532-5205
(228) 396-8460
(228) 396-1141
Mailing address
4105 HOSPITAL ST, SUITE 104, PASCAGOULA, MS 39581-5312
(228) 696-9224
(228) 696-9228
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C2692
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07703301
—
MS
01
—
C2692
LCSW LICENSE
MS
Enumeration date
04/02/2007
Last updated
10/13/2014
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