Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 561 | MS |
NPI | 1003332875 |
---|---|
Provider Name | Lynda Toney |
First Address | Hattiesburg, MS 39404-8679 |
Second Address | Prentiss, MS 39474-0979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2017 |
Last Update Date | 14/08/2017 |