Individual
MRS. LAKECIA P. WAITES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18373 ROBINSON RD, GULFPORT, MS 39503
(228) 243-5299
Mailing address
18373 ROBINSON ROAD, GULFPORT, MS 39503
(228) 243-5299
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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