person
Icerica Gardner
Mental Health Counselor in Hattiesburg, Mississippi
NPI 1295460509

Icerica Gardner is a Mental Health Counselor based in Hattiesburg, MS and is specialized in Mental Health. Icerica Gardner practices in Hattiesburg, MS. The NPI Number for Icerica Gardner is 1295460509 and holds a License No. 4967 (Mississippi).

The current practice location address for Icerica Gardner is 110 Patton Ave, Hattiesburg, MS and can be reached out via phone at 601-582-1111 and via fax at 601-450-0765.

Location: 110 Patton Ave, Hattiesburg, MS, 39404-8679
person
Provider Profile Details
NPI Number
1295460509
Provider Name
Icerica Gardner
Credential
Provider Entity Type
Individual
Gender
Female
Address
110 Patton Ave, Hattiesburg, MS, 39404-8679
Phone Number
601-582-1111
Fax Number
601-450-0765
Provider Enumeration Date
07/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Patton Ave
City
State
Zip
39401-6155
Phone Number
601-582-1111
Fax Number
601-450-0765
person
Provider Business Mailing Address Details
Address
110 Patton Ave
City
State
Zip
39401-6155
Phone Number
601-582-1111
Fax Number
601-450-0765
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
4967 (Mississippi)
Definition
Definition to come...
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