Individual
MRS. TRACY O. GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC, NCSC, LSW,
Contact information
Practice address
401 E WALDRON ST STE B, CORINTH, MS 38834-4707
(662) 396-1167
Mailing address
PO BOX 1620, CORINTH, MS 38835-1620
(662) 396-1167
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1283
MS
Other
Enumeration date
06/30/2019
Last updated
12/04/2019
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