Individual
MR. LEMICHAL DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCRP
Contact information
Practice address
5773 OLD CANTON RD, JACKSON, MS 39211-3202
(601) 994-4647
Mailing address
5773 OLD CANTON RD, JACKSON, MS 39211-3202
(601) 994-4647
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
174H00000X
Health Educator
—
—
Other
Enumeration date
05/11/2016
Last updated
08/27/2019
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