Individual
MICHELLE A DEDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 COURTHOUSE RD STE G, GULFPORT, MS 39507-1890
(228) 897-7465
Mailing address
302 COURTHOUSE RD STE G, GULFPORT, MS 39507-1890
(228) 897-7465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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