MEDICARE: RANESHA ESPECTO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2905	MS

General Provider Information

NPI Number	:	1265148472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANESHA ESPECTO LPC

Provider Business Mailing Address
First Line	:	1417 S DAVIS AVE # B
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-4316
Country	:	US
Telephone Number	:	662-404-1562
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 S DAVIS AVE # B
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-4316
Country	:	US
Telephone Number	:	662-404-1562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	01/31/2023

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Directions to “ RANESHA ESPECTO LPC” Practice Location

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