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General NPI Number Information
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NPI Number | 1114662145
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Entity Type | Organization
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Legal Business Name | HATTIESBURG PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 34 MILLBRANCH RD STE 80
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City | HATTIESBURG
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State | MS
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Zip | 39402-1687
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Country | US
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Telephone | 601-909-9394
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Fax | 601-909-9383
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Provider Business Mailing Address
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Address Line | 34 MILLBRANCH RD STE 80
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City | HATTIESBURG
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State | MS
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Zip | 39402-1687
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Country | US
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Telephone | 601-909-9394
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Fax | 601-909-9383
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Authorized Official
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Title or Position | EMPLOYEE
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Name | NEELOU PATEL
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Credential | PMHNP
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Telephone | 601-329-1268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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