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General NPI Number Information
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NPI Number | 1265177687
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Entity Type | Individual
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Provider Name | DENNIS FRANKLIN GREGORY LMFT
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Gender | Male
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 210 W JACKSON ST
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City | RIDGELAND
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State | MS
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Zip | 39157-2312
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Country | US
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Telephone | 662-392-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 7298 HIGHWAY 18 W
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City | MENDENHALL
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State | MS
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Zip | 39114-9206
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Country | US
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Telephone | 662-392-1035
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T-0064
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License Number State | MS
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