Individual
YOLANDA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5696 LANCASTER DR, OLIVE BRANCH, MS 38654-9319
(662) 782-8888
Mailing address
5696 LANCASTER DR, OLIVE BRANCH, MS 38654-9319
(662) 782-8888
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
851719752
STATE OF MISSISSIPPI
MS
Enumeration date
09/22/2022
Last updated
09/22/2022
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