Individual
LATRICE FOX DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6920 OAK FOREST DR, OLIVE BRANCH, MS 38654-1332
(662) 892-2660
(662) 200-5842
Mailing address
2430 JOHNNY WALKER RD, POTTS CAMP, MS 38659-9310
(662) 688-5848
(662) 688-5848
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M10447
MS
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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