Healthcare Provider Details

I. General information

NPI: 1467948091
Provider Name (Legal Business Name): L & A SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S DAVIS AVE
CLEVELAND MS
38732-4312
US

IV. Provider business mailing address

1501 FERRIS DR
CLEVELAND MS
38732-2943
US

V. Phone/Fax

Practice location:
  • Phone: 662-402-0119
  • Fax:
Mailing address:
  • Phone: 662-402-0119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number116142
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number116142
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number116142
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number116142
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number116142
License Number StateMS

VIII. Authorized Official

Name: DR. LINDER HOWZE
Title or Position: DIRECTOR/PSYCHOLOGIST
Credential: PHD
Phone: 662-402-0119