Individual
JOANETTA MARIE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLOGIST
Contact information
Practice address
806 S 28TH AVE, HATTIESBURG, MS 39402-2601
(601) 606-7652
Mailing address
PO BOX 18956, HATTIESBURG, MS 39404-8956
(662) 967-1741
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
00-12147
MS
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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