Individual
TARISHAN WINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(662) 510-5980
Mailing address
1907 TALISKER DR, CORDOVA, TN 38016-0154
(662) 910-8730
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PA00335
MS
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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