| Doctor Name: | REGINALD GANDY |
| NPI Number: | 1508167420 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS |
| License Number: | |
| Business Practice Address: | 100 Old Sturgis Rd Ackerman, MS - 397356600 |
| Business Phone Number: | 6622859225 |
| Business Fax Number: | 6622856226 |
| Mailing Address: | 1032 State Hwy 50 W, WEST POINT |
| State: | MS |
| Postal Code: | 39773 |
| Phone Number: | 6625244347 |
| Fax Number: | 6625244370 |
| NPI Enumeration Date: | 11/09/2010 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |