Individual
KEITHA LATRICE BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5281 NAVY RD, MILLINGTON, TN 38053-2535
(901) 873-0305
Mailing address
4375 HIGHWAY 51 N APT 25-103, HORN LAKE, MS 38637-8720
(901) 371-7185
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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