Play Fabulous | |
9761 Dorothy Dr Olive Branch MS 38654-6598 | |
(901) 412-2720 | |
Not Available |
Full Name | Play Fabulous |
---|---|
Speciality | Community/behavioral Health |
Location | 9761 Dorothy Dr, Olive Branch, Mississippi |
Authorized Official Name and Position | Stacey Denise Guthrie-aldinger (LICENSED PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 9014122720 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Play Fabulous 9761 Dorothy Dr Olive Branch MS 38654-6598 Ph: (901) 412-2720 | Play Fabulous 9761 Dorothy Dr Olive Branch MS 38654-6598 Ph: (901) 412-2720 |
NPI Number | 1598129090 |
---|---|
Provider Enumeration Date | 04/11/2016 |
Last Update Date | 04/11/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598129090 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1239 (Mississippi) | Primary |
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