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General NPI Number Information
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NPI Number | 1093214751
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Entity Type | Organization
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Legal Business Name | LINDA SWEEZER ENTERPRISES, LLC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 1301 HOLLY ST
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City | VICKSBURG
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State | MS
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Zip | 39180-3665
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Country | US
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Telephone | 601-630-3362
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Fax | 855-540-0718
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Provider Business Mailing Address
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Address Line | PO BOX 820364
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City | VICKSBURG
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State | MS
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Zip | 39182-0364
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Country | US
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Telephone | 601-218-1322
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Fax | 855-540-0718
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | MRS. LINDA LEE SWEEZER
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Credential |
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Telephone | 601-218-1322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CO962
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License Number State | MS
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