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Individual

DR. CANDACE L. GILLESPIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED. D., NCC, LPC

Contact information

Practice address
829 W SOUTH ST, MOUND BAYOU, MS 38762-9797
(662) 588-2481
Mailing address
829 W SOUTH ST, MOUND BAYOU, MS 38762-9797
(662) 588-2481

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6979
101YP2500X
Professional Counselor
Primary
1074
MS
101YS0200X
School Counselor
173503
MS

Other

Enumeration date
08/13/2020
Last updated
08/13/2020
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