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CHASITY CHERE' BLAKELY B.S. PYSCHOLOGY

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1831522911

Individual Registrant:
 CHASITY CHERE' BLAKELY B.S. PYSCHOLOGY
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3407 SHAMROCK CT  GAUTIER, MS 39553-5337 US
Tel: 228-497-0690  Fax: 228-497-1363

Contact information for business:
3407 SHAMROCK CT  GAUTIER, MS 39553-5337 US
Tel: --  Fax: --

Registration Information:
NPI: 1831522911
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00018214MS05




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