Individual
BREANNA CHRISTINA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CHES
Contact information
Practice address
1647 ROBINSON ST APT B, JACKSON, MS 39209-6424
(601) 850-9500
Mailing address
1647 ROBINSON ST APT B, JACKSON, MS 39209-6424
(601) 850-9500
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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