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Individual

MRS. TOMEKA MAYS GANTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
452 LAKESHORE PKWY STE 230, ROCK HILL, SC 29730-4291
(704) 968-4893
Mailing address
9029 GERALD DR, CHARLOTTE, NC 28217-3080
(704) 968-4893

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4417
NC
101YP2500X
Professional Counselor
Primary
4620
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6102506
NC
Enumeration date
12/21/2006
Last updated
07/08/2007
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