Individual
MRS. GWENESSA VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Mailing address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-5274
(662) 378-3976
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
M3658
MS
104100000X
Social Worker
M3658
MS
1041C0700X
Clinical Social Worker
M3658
MS
106H00000X
Marriage & Family Therapist
M3658
MS
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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