Healthcare Provider Details

I. General information

NPI: 1275966749
Provider Name (Legal Business Name): ERIN DEHON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST DEPT OF EMERGENCY MEDICINE
JACKSON MS
39216-4500
US

IV. Provider business mailing address

PO BOX 11407 DEPT 2130
BIRMINGHAM AL
35246-2130
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-5571
  • Fax:
Mailing address:
  • Phone: 601-925-6805
  • Fax: 601-926-4971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number53920
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: