Individual
DANA ALEXIS MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCMHT
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MS
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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