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Individual

GEOFFREY HANNAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCSS

Contact information

Practice address
41 BONHOMIE RD, HATTIESBURG, MS 39401-8648
(601) 450-0431
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BC0511
MS

Other

Enumeration date
08/14/2017
Last updated
08/14/2017
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