Connolly, Kevin Mark
Connolly, Kevin Mark is an individual health care provider with primary practice located at 1500 E Woodrow Wilson Ave (116A2), Jackson MS 39216-5116. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Connolly, Kevin Mark can be contacted via phone (601) 362-4471.Contact Information
Primary practice address
1500 E Woodrow Wilson Ave (116A2)
Jackson MS 39216-5116
Phone: (601) 362-4471
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 49845 | Mississippi |
Profile Details
| NPI number | 1821229360 |
|---|---|
| LBN Legal business name | Connolly, Kevin Mark |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2009 |
| Last updated | Aug 19th, 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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