Individual
LAUREN ANTOINETTE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 S 12TH AVE, LAUREL, MS 39440-4322
(601) 342-8125
Mailing address
800 E RIVER PL STE 100, JACKSON, MS 39202-3402
(313) 645-6515
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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