Individual
TABITHA GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
(662) 289-4735
Mailing address
2504 BROWNING ROAD 520, GREENWOOD, MS 38930-6022
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MS
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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