Individual
KEITH GUNNERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
132 RALEIGH CT, STATESBORO, GA 30458-0160
(912) 225-6920
Mailing address
PO BOX 2405, STATESBORO, GA 30459-2405
(912) 225-6920
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY004627
GA
Other
Enumeration date
08/12/2013
Last updated
07/31/2024
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