Provider Demographics
NPI:1063705853
Name:PAPADIMITRIOU, EKATERINI
Entity type:Individual
Prefix:
First Name:EKATERINI
Middle Name:
Last Name:PAPADIMITRIOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6942
Mailing Address - Country:US
Mailing Address - Phone:662-842-9217
Mailing Address - Fax:662-680-6416
Practice Address - Street 1:339 LEGION LN
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-8978
Practice Address - Country:US
Practice Address - Phone:662-509-9300
Practice Address - Fax:662-509-6698
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health