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Individual

CRENICIA JAILA GAUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
943 W ANDREWS AVE STE H, HENDERSON, NC 27536-2562
(252) 433-0061
Mailing address
144 LILLY LN, HENDERSON, NC 27537-3786
(252) 767-1505

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C013261
NC
1041C0700X
Clinical Social Worker
Primary
P012770
NC

Other

Enumeration date
07/20/2018
Last updated
10/06/2020
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