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General NPI Number Information
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NPI Number | 1538107164
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Entity Type | Individual
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Provider Name | JERI HUGHES SQUYRES LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 2279 ATKINSON RD
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City | BILOXI
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State | MS
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Zip | 39531-2209
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Country | US
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Telephone | 228-865-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 809 CANEBREAK DR
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-6836
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Country | US
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Telephone | 228-523-5000
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Fax | 228-523-4628
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904002956
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License Number State | VA
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