Upa Pllc Ped Psychology
NPI #1467505222 in Jackson, Mississippi
Provider Information
- NPI Number
- 1467505222
- Entity Type
- Organization
- Organization Name
- Upa Pllc Ped Psychology
- Primary Specialty
- Psychologist - Cognitive & Behavioral
- Enumeration Date
- Jan 18, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2500 N STATE ST
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39216-4500
- Phone
- (601) 984-5274
Authorized Official
- Name
- DR. OWEN B EVANS, M.D.
- Title
- MANAGER
- Phone
- (601) 984-5214
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Cognitive & Behavioral — Cognitive & Behavioral |
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