Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | P548 | MS |
NPI | 1003447020 |
---|---|
Provider Name | Cari Ann Gaunt |
First Address | Petal, MS 39465-4002 |
Second Address | Hattiesburg, MS 39401-3825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2020 |
Last Update Date | 29/01/2020 |