Icerica Gardner
Icerica Gardner is a Mental Health Counselor in Hattiesburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2022.
- Licensed in
- MS
- In the registry since
- 2022
Practice location Address checks out
110 Patton AveHattiesburg, MS 39401-6155
Phone: (601) 582-1111
Fax: (601) 450-0765
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X · Licence 4967 (MS) |
|---|
Record details
| NPI number | 1295460509 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | July 20, 2022 |
| Last updated in NPPES | July 20, 2022 |
| Certification date | July 20, 2022 |
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