Individual
WENDY GEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MS
104100000X
Social Worker
M9775
MS
Other
Enumeration date
08/30/2019
Last updated
11/17/2020
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