Individual
MR. GAREY ALLEN BONNER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
607 CORINNE ST STE A1, HATTIESBURG, MS 39401-3831
(601) 408-9624
Mailing address
607 CORINNE ST STE A1, HATTIESBURG, MS 39401-3831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1881
MS
Other
Enumeration date
09/14/2017
Last updated
09/14/2017
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