Individual
MS. TAMMY LOUISE LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
166 WOODLAND WAY, JACKSON, MS 39209-3566
(601) 965-6749
Mailing address
166 WOODLAND WAY, JACKSON, MS 39209-3566
(601) 965-6749
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/28/2020
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