Individual
MRS. RUBY DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1723 MAIN ST, SOUTHAVEN, MS 38671-1238
(662) 655-0105
Mailing address
1723 MAIN ST, SOUTHAVEN, MS 38671-1238
(662) 655-0105
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
1165308
MS
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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