Prestage, Mary Elizabeth

Prestage, Mary Elizabeth is an individual health care provider with primary practice located at 113A S Davis Ave , Cleveland MS 38732-3447. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Prestage, Mary Elizabeth can be contacted via phone (662) 843-9445.

Contact Information

Primary practice address
113A S Davis Ave Cleveland MS 38732-3447
Phone: (662) 843-9445
Fax: (662) 843-9447
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 942 Mississippi

Profile Details

NPI number 1548445299
LBN Legal business name Prestage, Mary Elizabeth
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2007
Last updated Jan 11th, 2008 - about 16 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 1548445299 NPPES
Mississippi MEDICAID 0018205

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