Individual
SHANNON GAUTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 HUNTINGTON HILL DR, CLINTON, MS 39056-6322
(601) 259-8003
Mailing address
PO BOX 701, CLINTON, MS 39060-0701
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MS
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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