Individual
GRADY RICHARD CORBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2224 25TH AVE, GULFPORT, MS 39501-4520
(479) 244-0495
Mailing address
2501 GULF AVE APT 29, GULFPORT, MS 39501-3436
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
222
MS
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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