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General NPI Number Information
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NPI Number | 1447847728
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Entity Type | Individual
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Provider Name | JUDY ANNE GUERIN LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 10532 AUTO MALL PKWY STE D
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City | DIBERVILLE
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State | MS
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Zip | 39540-3708
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Country | US
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Telephone | 228-828-5208
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Fax | 228-220-4303
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Provider Business Mailing Address
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Address Line | 10532 AUTO MALL PKWY STE D
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City | DIBERVILLE
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State | MS
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Zip | 39540-3708
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Country | US
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Telephone | 228-828-5208
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Fax | 228-220-4303
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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 | C11571
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License Number State | MS
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