Organization
MAGNOLIA COUNSELING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY WILLIAMS GOSS LPN (OFFICE MANAGER)
(662) 563-8703
Entity
Organization
Contact information
Practice address
590 HIGHWAY 6 E, BATESVILLE, MS 38606-3002
(662) 563-8703
Mailing address
590 HIGHWAY 6 E, BATESVILLE, MS 38606-3002
(662) 563-8703
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
01/13/2020
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