Individual
DIASHA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12007 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8907
(228) 392-2388
Mailing address
12007 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8907
(228) 392-2388
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100906
MS
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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