Individual
LE'BRIANNA FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3747 DORRIE CIR, SOUTHAVEN, MS 38672-2321
(901) 834-6711
Mailing address
3747 DORRIE CIR, SOUTHAVEN, MS 38672-2321
(901) 834-6711
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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