Individual
JILLIAN N WOODLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15432 MIMOSA DR, GULFPORT, MS 39503-2757
(228) 861-0703
Mailing address
15432 MIMOSA DR, GULFPORT, MS 39503-2757
(228) 861-0703
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CH1215
MS
Other
Enumeration date
08/14/2009
Last updated
10/25/2022
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