Individual
RENEE GUSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2434 PASS RD # D-13, BILOXI, MS 39531-2121
(228) 641-7561
Mailing address
930 JEFFERSON DR, GULFPORT, MS 39507-3816
(228) 641-7561
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YS0200X
School Counselor
216241
MS
246RP1900X
Phlebotomy Technician
133994
MS
251E00000X
Home Health Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
861387167
MOBILE PHEBOTOMY
—
Enumeration date
08/07/2020
Last updated
06/21/2023
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