Individual
KEELEY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSS
Contact information
Practice address
805 HIGHWAY 589, PURVIS, MS 39475-4194
(601) 794-6543
(601) 794-2455
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3684
MS
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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