# GULF COAST WELLNESS CENTER INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Gulf Coast Wellness Center Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790275956
- **Authorized official:** DR. MINNIE O'BANNER DD, MSSW, LMFT (LICENSED MARRIAGE FAMILY THERAPTIST)
- **Authorized official phone:** (228) 388-6282

## Contact information

- **Practice address:** 2318 PASS RD STE 7C, BILOXI, MS 39531
- **Practice address phone:** (228) 388-6282
- **Practice address fax:** (228) 388-7150
- **Mailing address:** 2318 PASS RD STE 7C, BILOXI, MS 39531-4044
- **Mailing address phone:** (228) 388-6282
- **Mailing address fax:** (228) 388-7150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | T0233 | MS | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | 16798 | MS | — |

## Other

- **Enumeration date:** 05/14/2018
- **Last updated:** 06/13/2018