Individual
AMY LATRICE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2623 5TH ST N, COLUMBUS, MS 39705-2009
(662) 241-7097
(662) 245-0511
Mailing address
1867 CRANE RIDGE DR STE 150C, JACKSON, MS 39216-4982
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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