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General NPI Number Information
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NPI Number | 1679908016
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Entity Type | Individual
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Provider Name | KATHRYN JADE WHITE GARRARD AUD-CCCA
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Gender | Female
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 3017 13TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-1833
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Country | US
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Telephone | 228-863-6592
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Fax |
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Provider Business Mailing Address
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Address Line | 12025 SARACENNIA RD
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City | MOSS POINT
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State | MS
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Zip | 39562-7759
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Country | US
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Telephone | 251-367-6128
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A3795
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License Number State | MS
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