Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 2244 | AL |
NPI | 1063166197 |
---|---|
Provider Name | Kray A Scully |
First Address | Biloxi, MS 39531-2410 |
Second Address | Biloxi, MS 39531-2410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2022 |
Last Update Date | 08/02/2022 |