Individual
BRIAN WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHT
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(288) 631-1322
Mailing address
PO BOX 6705, GULFPORT, MS 39506-6705
(288) 651-3302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5105
MS
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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