Individual
TERRI GHOLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
939 N MAIN ST STE B, HATTIESBURG, MS 39401-3708
(601) 596-4363
Mailing address
939 N MAIN ST STE B, HATTIESBURG, MS 39401-3708
(601) 596-4363
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
MS
Other
Enumeration date
10/13/2023
Last updated
11/09/2023
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