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General NPI Number Information
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NPI Number | 1942497169
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Entity Type | Organization
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Legal Business Name | SALLY KATE WINTERS FAMILY SERVICES
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 317 N DIVISION ST
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City | WEST POINT
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State | MS
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Zip | 39773-2439
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Country | US
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Telephone | 662-494-4867
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Fax | 662-494-0870
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Provider Business Mailing Address
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Address Line | PO BOX 1233
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City | WEST POINT
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State | MS
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Zip | 39773-1233
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Country | US
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Telephone | 662-494-4867
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Fax | 662-494-0870
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SHEILA G. BRAND
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Credential |
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Telephone | 662-494-4867
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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 | C5787
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License Number State | MS
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