Individual
MONIQUE D GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIDDT
Contact information
Practice address
102 CONTINENTAL DR, HATTIESBURG, MS 39402-9301
(601) 705-1901
Mailing address
102 CONTINENTAL DR, HATTIESBURG, MS 39402-9301
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0483
MS
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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