Oliver, Michael Tennis

Oliver, Michael Tennis is an individual health care provider with primary practice located at 4579 S Eason Blvd , Tupelo MS 38801-6539. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Oliver, Michael Tennis can be contacted via phone (662) 377-3161.

Contact Information

Primary practice address
4579 S Eason Blvd Tupelo MS 38801-6539
Phone: (662) 377-3161
Fax: (662) 377-2993
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 25327 Mississippi

Profile Details

NPI number 1043259369
LBN Legal business name Oliver, Michael Tennis
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043259369 NPPES
Mississippi MEDICAID 04331003

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