Provider Demographics
NPI:1326770355
Name:HESTER, MASON
Entity Type:Individual
Prefix:
First Name:MASON
Middle Name:
Last Name:HESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 PALESTINE RD
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-7242
Mailing Address - Country:US
Mailing Address - Phone:662-640-4595
Mailing Address - Fax:
Practice Address - Street 1:2535 PALESTINE RD
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-7242
Practice Address - Country:US
Practice Address - Phone:662-640-4595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health