Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1104447010 |
---|---|
Provider Name | Mrs. Elizabeth Singletary Eddleman |
First Address | Oxford, MS 38655-2944 |
Second Address | Oxford, MS 38655-2944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2020 |
Last Update Date | 01/05/2020 |