NPI 1104456698

Abigail Gamble, PHDMS

Practitioner Prevention Professional Jackson, MS

Practice location

Address: 2500 N State St, Jackson, MS 39216-4500
Phone: (601) 815-9065

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence NA (MS)

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Registry record

NPI: 1104456698
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jan 2020
Record last updated: 23 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.