Individual
KELLY HOLLOMAN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7165 GETWELL RD BLDG G, SOUTHAVEN, MS 38672-9619
(662) 349-2818
Mailing address
1070 PERKINS TER, MEMPHIS, TN 38117-5506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
03/04/2013
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