Individual
MR. CECIAL GANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCA
Contact information
Practice address
185 S KIMBALL AVE, SOUTHLAKE, TX 76092-1523
(817) 756-1440
Mailing address
11616 CEDAR GRV, ROANOKE, TX 76262-1867
(214) 263-7698
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
83274
TX
Other
Enumeration date
09/11/2021
Last updated
09/11/2021
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