Jolly, John B.
Jolly, John B. is an sole proprietor health care provider with primary practice located at 740 Avignon Dr Ste B , Ridgeland MS 39157-5160. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jolly, John B. can be contacted via phone (601) 355-8378.Contact Information
Primary practice address
740 Avignon Dr Ste B
Ridgeland MS 39157-5160
Phone: (601) 355-8378
Fax: (601) 354-5535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 33-531 | Mississippi |
Profile Details
| NPI number | 1629192083 |
|---|---|
| LBN Legal business name | Jolly, John B. |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Nov 9th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629192083 | NPPES |
| Mississippi | MEDICAID | 00114506 |
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