Individual
TIARA PERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6441 CHICKASAW ST, MARION, MS 39342-9504
(601) 621-2512
Mailing address
6441 CHICKASAW ST, MARION, MS 39342-9504
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
MS
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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