Individual
ABBY HAVARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
DSU BOX A3, CLEVELAND, MS 38733
(662) 719-6700
Mailing address
1210 SIXTH AVE, CLEVELAND, MS 38732-3606
(662) 719-6700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT0582
STATE LICENSURE
MS
Enumeration date
11/29/2018
Last updated
11/29/2018
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