Individual
NGECHE GANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2705 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(662) 449-1972
Mailing address
2705 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(662) 449-1972
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
MSW006734
GA
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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