Individual
LORA BLADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
9230 OLD LORRAINE RD UNIT A, GULFPORT, MS 39503-6059
(228) 731-3500
Mailing address
22 MILLBRANCH RD, HATTIESBURG, MS 39402-1670
(601) 255-5264
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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