Individual
KATHY ULLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P-LPC
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(122) 886-5133
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(288) 631-1322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P-0541
MS
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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