| Midsouth Behavioral Health, Pllc | |
|
6810 Crumpler Blvd Suite 302 Olive Branch MS 38654-1933 | |
| (662) 895-1707 | |
| (662) 893-0388 |
| Full Name | Midsouth Behavioral Health, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6810 Crumpler Blvd, Olive Branch, Mississippi |
| Authorized Official Name and Position | Merry Nichols (ACCTS. MANAGER) |
| Authorized Official Contact | 6628951707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Behavioral Health, Pllc Po Box 579 Olive Branch MS 38654-0579 Ph: (662) 895-1707 | Midsouth Behavioral Health, Pllc 6810 Crumpler Blvd Suite 302 Olive Branch MS 38654-1933 Ph: (662) 895-1707 |
| NPI Number | 1912084286 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912084286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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