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General NPI Number Information
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NPI Number | 1699285692
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Entity Type | Organization
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Legal Business Name | SOUTHERN ALTERNATIVE & INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 921 WALL ST STE B
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City | MCCOMB
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State | MS
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Zip | 39648-3161
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Country | US
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Telephone | 601-395-4073
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Fax | 601-395-9422
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Provider Business Mailing Address
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Address Line | 331 7TH ST
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City | MCCOMB
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State | MS
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Zip | 39648-4752
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Country | US
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Telephone | 601-395-4073
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TRISCH VEAL MCKINLEY
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Credential | NHC, CHW, DIRECTOR
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Telephone | 601-395-4073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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