Healthcare Provider Details

I. General information

NPI: 1669102927
Provider Name (Legal Business Name): OXFORD PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 W OXFORD LOOP STE 114H
OXFORD MS
38655-5728
US

IV. Provider business mailing address

2704 W OXFORD LOOP STE 114H
OXFORD MS
38655-5728
US

V. Phone/Fax

Practice location:
  • Phone: 228-324-5790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY KINMAN
Title or Position: OWNER
Credential: PHD
Phone: 228-324-5790