Individual
ESMERELDA GORDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91180 HIGHWAY 42, RICHTON, MS 39476-9254
(601) 788-6308
(601) 788-6349
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
5349
MS
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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