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Jim Alfred Deloach
Peer Specialist in Gautier, Mississippi
NPI 1205554656

Jim Alfred Deloach is a Peer Specialist based in Gautier, MS. Jim Alfred Deloach practices in Gautier, MS. The NPI Number for Jim Alfred Deloach is 1205554656 and holds a License No. (Mississippi).

The current practice location address for Jim Alfred Deloach is 330B Highway 90, Gautier, MS and can be reached out via phone at 228-497-0434. You can also correspond with Jim Alfred Deloach through the mailing address at 3407 SHAMROCK CT, GAUTIER, MS - 39553-5337 (mailing address contact number: ).

Location: 330B Highway 90, Gautier, MS, 39553-5337
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Provider Profile Details
NPI Number
1205554656
Provider Name
Jim Alfred Deloach
Credential
Provider Entity Type
Individual
Gender
Male
Address
330B Highway 90, Gautier, MS, 39553-5337
Phone Number
228-497-0434
Fax Number
Provider Enumeration Date
08/19/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018214 05 MS
institution
Provider Business Practice Location Address Details
Address
330B Highway 90
City
State
Zip
39553-5744
Phone Number
228-497-0434
Fax Number
person
Provider Business Mailing Address Details
Address
330B Highway 90
City
State
Zip
39553-5744
Phone Number
228-497-0434
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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