Individual
DARBY GRACE BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1465 LAKELAND DR, JACKSON, MS 39216-4719
(601) 352-7784
Mailing address
110 ST REGIS DR, MADISON, MS 39110-7798
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-298395
MS
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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