Organization
GULF COAST WELLNESS CENTER INC
Active
Other names
Gulf Coast Wellness Center Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MINNIE O'BANNER DD, MSSW, LMFT (LICENSED MARRIAGE FAMILY THERAPTIST)
(228) 388-6282
Entity
Organization
Contact information
Practice address
2318 PASS RD STE 7C, BILOXI, MS 39531
(228) 388-6282
(228) 388-7150
Mailing address
2318 PASS RD STE 7C, BILOXI, MS 39531-4044
(228) 388-6282
(228) 388-7150
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0233
MS
208100000X
Physical Medicine & Rehabilitation Physician
16798
MS
Other
Enumeration date
05/14/2018
Last updated
06/13/2018
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