| NPI | 1790275956 |
|---|---|
| Doing Business As | GULF COAST WELLNESS CENTER INC |
| Entity Type | Organization |
| Authorized Contact | MINNIE O'BANNER Licensed Marriage Family Theraptist 228-388-6282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MS T0233) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MS 16798) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-06-13 |