Individual
LATEISHA SHAVONTE CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
808 OGLE ST, ABERDEEN, MS 39730-3626
(662) 646-0183
Mailing address
808 OGLE ST, ABERDEEN, MS 39730-3626
(662) 646-0183
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
801063923
MS
Other
Enumeration date
04/02/2025
Last updated
04/26/2025
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