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Individual

JAN GANANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
100 OLD STURGIS RD, ACKERMAN, MS 39735-6600
(662) 285-6225
(662) 285-6226
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9261
(662) 324-9647

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
104343
MS

Other

Enumeration date
01/05/2010
Last updated
01/05/2010
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