person
Sir Johnathan Rucker
Mental Health Counselor in Yazoo City, Mississippi
NPI 1578022281

Sir Johnathan Rucker is a Mental Health Counselor based in Yazoo City, MS and is specialized in Mental Health. Sir Johnathan Rucker practices in Yazoo City, MS. The NPI Number for Sir Johnathan Rucker is 1578022281 and holds a License No. (Mississippi).

The current practice location address for Sir Johnathan Rucker is 635 W Willie Morris Pkwy, Yazoo City, MS and can be reached out via phone at 601-638-0031 and via fax at 601-638-1778.

Location: 635 W Willie Morris Pkwy, Yazoo City, MS, 39194-7702
person
Provider Profile Details
NPI Number
1578022281
Provider Name
Sir Johnathan Rucker
Credential
Provider Entity Type
Individual
Gender
Male
Address
635 W Willie Morris Pkwy, Yazoo City, MS, 39194-7702
Phone Number
601-638-0031
Fax Number
601-638-1778
Provider Enumeration Date
03/13/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018215 05 MS
institution
Provider Business Practice Location Address Details
Address
635 W Willie Morris Pkwy
City
State
Zip
39194-7702
Phone Number
601-638-0031
Fax Number
601-638-1778
person
Provider Business Mailing Address Details
Address
635 W Willie Morris Pkwy
City
State
Zip
39194-7702
Phone Number
601-638-0031
Fax Number
601-638-1778
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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