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General NPI Number Information
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NPI Number | 1215480991
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Entity Type | Individual
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Provider Name | SANJUANITA ARREDONDO LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 417 SECURITY SQ
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City | GULFPORT
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State | MS
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Zip | 39507-1922
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Country | US
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Telephone | 707-728-5131
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Fax | 855-491-1095
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Provider Business Mailing Address
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Address Line | PO BOX 255
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City | GULFPORT
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State | MS
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Zip | 39502-0255
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Country | US
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Telephone | 707-728-5131
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Fax | 855-491-1095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C8063
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License Number State | MS
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