Individual
C DIANE M ALLGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, PCMHT
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1780
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CH3255
MS
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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