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Individual
MR. MILTON JAY GANTT II
Active
Individual
MR. MILTON JAY GANTT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
25667
TX
1041C0700X
Clinical Social Worker
Primary
25667
TX
171M00000X
Case Manager/Care Coordinator
220041512
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25667
SOCIAL WORK LICENSE
TX
Enumeration date
12/12/2006
Last updated
01/26/2017
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