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General NPI Number Information
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NPI Number | 1396218830
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Entity Type | Individual
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Provider Name | HEATHER D KENT LPC
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Gender | Female
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 969 LAKELAND DR
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City | JACKSON
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State | MS
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Zip | 39216-4606
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Country | US
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Telephone | 601-200-3158
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Fax |
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Provider Business Mailing Address
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Address Line | 107 TRADITION PKWY
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City | FLOWOOD
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State | MS
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Zip | 39232-8021
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Country | US
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Telephone | 601-946-3640
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0690
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License Number State | MS
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