Brett Tyler Dillard, B.S.W.

Individual provider Active NPI Mental Health Counselor · Pontotoc, MS

NPI 1003136672 · NPPES record last updated Jun 7, 2010

Key facts

NPI
1003136672
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
39 Lafayette St
Pontotoc, MS 38863-2837
Phone
(662) 509-6759
Fax
(662) 509-6761
NPI assigned
Jun 7, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

39 Lafayette St
Pontotoc, MS 38863-2837

Mailing address

39 Lafayette St
Pontotoc, MS 38863-2837
Phone (662) 509-9300

Other providers in Pontotoc, MS

All providers in Pontotoc, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.