Individual
MS. SONAL BHAKTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9080 LACEY DR, SOUTHAVEN, MS 38671-1439
(662) 253-8905
Mailing address
1782 TREESTAND RD, SOUTHAVEN, MS 38672-2009
(901) 326-9707
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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