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RICHARD PHILLIP GANTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
Mailing address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104898
KY
101YP2500X
Professional Counselor
Primary
104898
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104898
KY LICENSE
KY
Enumeration date
04/20/2007
Last updated
03/15/2024
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