Individual
JOAN S WALDROUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1403 43RD AVE, GULFPORT, MS 39501-2545
(228) 234-9460
Mailing address
PO BOX 7475, GULFPORT, MS 39506-7475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6319
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01535581
—
MS
Enumeration date
07/28/2006
Last updated
12/16/2025
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