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NPI Code Detail

MEDICARE: VALENCIA BINGHAM

MEDICARE: VALENCIA BINGHAM
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1609333251
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALENCIA BINGHAM
Provider Business Mailing Address
First Line : 706 HIGHWAY 51 N
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2366
Country : US
Telephone Number : 601-990-2513
Fax Number :
Provider Business Practice Location Address
First Line : 706 HIGHWAY 51 N
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2366
Country : US
Telephone Number : 601-990-2513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2019
Last Update Date : 03/01/2019

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Directions to “ VALENCIA BINGHAM ” Practice Location

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