Individual provider · Type 1 NPI
Mark Tyner Hagwood, D.P.C.
Professional Counselor · Ridgeland, MS
NPI number
1134528821
Active
Practice location
128 Maple Drive, Suite A
Ridgeland, MS 39157
Mailing address
137 Highwoods Blvd
Madison, MS 39110-7423
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 1924 (MS) |
Professional Counselor: Definition to come...
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About NPI 1134528821
Mark Tyner Hagwood, D.P.C.'s National Provider Identifier is 1134528821, issued on Aug 19, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Ridgeland, MS. The record was last updated on Oct 8, 2014.