Individual
LARALEIGH ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4182 WILD DUCK DR, LAUDERDALE, MS 39335-9515
(601) 604-9983
Mailing address
4182 WILD DUCK DR, LAUDERDALE, MS 39335-9515
(601) 604-9983
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2879
AL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
11/28/2022
Last updated
09/23/2024
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