Individual
MRS. LETHA DEMETRA WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 S HIGH SCHOOL AVE, COLUMBIA, MS 39429-3414
(601) 736-1448
(601) 736-6067
Mailing address
306 S HIGH SCHOOL AVE, COLUMBIA, MS 39429-3414
(601) 736-4035
(601) 736-4037
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
343900000X
MS
376J00000X
Homemaker
376J00000X
MS
385H00000X
Respite Care
Primary
385H00000X
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01631705
—
MS
05
—
02323791
—
MS
05
—
03907701
—
MS
Enumeration date
12/21/2007
Last updated
01/22/2021
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