Most Relevant Information
Provider Data
| NPI Number: | 1003232786 |
| Provider Name: | JODI LEIGHANN CARLISLE MS COUNSELING PSYCHO |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/05/2014 |
| Last Updated: | 03/05/2014 |
Provider Practice Location
3407 SHAMROCK CT
GAUTIER
MS
395535337
Practice Location Phone/Fax
| Phone: | 2284970690 |
| Fax: | 2284971363 |
Provider Mailing Location
3407 SHAMROCK CT
GAUTIER
MS
395535337
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |