Individual provider · Type 1 NPI

Samonia Lynn Etheridge, LPC

Professional Counselor · Vicksburg, MS

NPI number 1619014891 Active

Practice location

1414 Cherry St
Vicksburg, MS 39180-3218

Call (601) 636-5703 Map

Fax (601) 636-5739

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X1046 (MS)

Professional Counselor: Definition to come...

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About NPI 1619014891

Samonia Lynn Etheridge, LPC's National Provider Identifier is 1619014891, issued on Jan 30, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Vicksburg, MS. The record was last updated on Jul 8, 2007.