NPI 1063096469

Saja B Mboge

Practitioner Clinical Social Worker Southaven, MS

Practice location

Address: 340 Stateline Rd W, Southaven, MS 38671-1610
Phone: (662) 510-5387
Fax: (662) 342-0782
Mailing address: 9216 Speerberry Ln, Cordova, TN 38016-0900

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence Q3-0010588 (DE)

Other Social Worker providers in Mississippi →

Registry record

NPI: 1063096469
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 May 2021
Record last updated: 11 May 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.