Individual
MRS. AJA DANIELLE GUICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-8352
Mailing address
4989 WINDMILL AVE, DIBERVILLE, MS 39540-8835
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
57257
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57257
NCTRC
—
Enumeration date
05/16/2019
Last updated
05/16/2019
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