Individual
LASHANDA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
428 24TH AVE N, COLUMBUS, MS 39705-1945
(662) 241-7097
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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