Organization · Type 2 NPI
Defining Wellness Medical Center
Behavioral Neurology & Neuropsychiatry Physician · Ridgeland, MS
NPI number
1053050591
Active
Practice location
411 Hanover Cir Ste 100
Ridgeland, MS 39157-8814
Fax (769) 241-2605
Mailing address
3949 Highway 43 N
Brandon, MS 39047-7240
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Group Psychotherapy Psychologist | 103TP2701X | None listed |
| Behavioral Neurology & Neuropsychiatry Physician Primary | 2084B0040X | None listed |
| Psychiatry Physician | 2084P0800X | None listed |
Behavioral Neurology & Neuropsychiatry Physician: Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues.
About NPI 1053050591
Defining Wellness Medical Center's National Provider Identifier is 1053050591, issued on Jun 2, 2022. The primary taxonomy on file is Behavioral Neurology & Neuropsychiatry Physician (2084B0040X), and the practice location is in Ridgeland, MS. The record was last updated on Jun 2, 2022.