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Individual

MR. JOHN ANTHONY CALDWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
210 E MAIN ST, STE 2B, TUPELO, MS 38804-4017
(662) 832-1658
(662) 620-7106
Mailing address
210 E MAIN ST, STE 2B, TUPELO, MS 38804-4017
(662) 832-1658
(662) 620-7106

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05255791
MS
Enumeration date
09/12/2006
Last updated
06/22/2015
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