Conner, Devonne Angela

Conner, Devonne Angela is an sole proprietor health care provider with primary practice located at 212 Broad St , Hattiesburg MS 39401-3603. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Conner, Devonne Angela can be contacted via phone (601) 582-5018.

Contact Information

Primary practice address
212 Broad St Hattiesburg MS 39401-3603
Fax: (601) 582-5018
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C7065 Mississippi

Profile Details

NPI number 1134394943
LBN Legal business name Conner, Devonne Angela
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2008
Last updated Jul 8th, 2013 - about 12 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 1134394943 NPPES
Mississippi MEDICAID 04132761

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