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General NPI Number Information
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NPI Number | 1760820351
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 404 ORCHARD PARK
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City | RIDGELAND
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State | MS
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Zip | 39157-5106
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Country | US
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Telephone | 601-206-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 153 HARTFIELD DR
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City | MADISON
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State | MS
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Zip | 39110-6545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | NAKEETSHA DRYER
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Credential | N.P.
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Telephone | 601-206-0023
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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 | 881934995
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License Number State | MS
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