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Contact Information

IMANI COMMUNITY OUTREACH CENTER
301 E JEFFERSON ST
KOSCIUSKO, MS39090-3719
 Phone: 662-289-7676
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for IMANI COMMUNITY OUTREACH CENTER · (Female)

NPI # 1467728360
Status Active
Credentials
Entity Individual
Enumeration date 03/26/2012
Last updated 03/26/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS License # W7478
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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