Broome, Melissa Southall

Broome, Melissa Southall is an individual health care provider with primary practice located at 2222 S Frontage Rd , Vicksburg MS 39180-5271. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Broome, Melissa Southall can be contacted via phone (601) 852-3271.

Contact Information

Primary practice address
2222 S Frontage Rd Vicksburg MS 39180-5271
Phone: (601) 852-3271
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 220005 Mississippi

Profile Details

NPI number 1053969097
LBN Legal business name Broome, Melissa Southall
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2019
Last updated Jan 24th, 2022 - about 4 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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