Tina Miles

Individual provider Active NPI Mental Health Counselor · Wiggins, MS

NPI 1720736770 · NPPES record last updated Mar 17, 2022

Key facts

NPI
1720736770
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
M6112 (MS)
Practice address
200 Coastal Paper Dr
Wiggins, MS 39577-7000
Phone
(601) 385-6095
Fax
(601) 928-5622
NPI assigned
Mar 17, 2022
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
M6112MSMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X M6112 MS Yes

Addresses

Primary practice location

200 Coastal Paper Dr
Wiggins, MS 39577-7000

Mailing address

PO Box 18679
Hattiesburg, MS 39404-8679
Phone (601) 705-1901

Other providers in Wiggins, MS

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

Sources for this page

Verify at the official NPI Registry.