Individual
ERICA GREGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 S 16TH AVE, HATTIESBURG, MS 39401-6250
(228) 297-7450
Mailing address
309 S 16TH AVE, HATTIESBURG, MS 39401-6250
(228) 297-7450
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA3162
MS
Other
Enumeration date
06/26/2016
Last updated
06/26/2016
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