Individual
LATANYA RENAE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
621 SAINT CHARLES ST, FLORA, MS 39071-9758
(601) 850-7036
Mailing address
621 SAINT CHARLES ST, FLORA, MS 39071-9758
(601) 850-7036
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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