ICERICA GARDNER

HATTIESBURG, MS
NPI1295460509
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: MS  4967)
Enumeration Date2022-07-20
Last Update Date2022-07-20
Business Address
ICERICA GARDNER
110 PATTON AVE
HATTIESBURG, MS 39401-6155
Phone number: 601-582-1111
Mailing Address
ICERICA GARDNER
PO BOX 18679
HATTIESBURG, MS 39404-8679
Phone number: 601-705-1901