Individual
JUDY DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
2100 CHAMBERS DRIVE, BOONEVILLE, MS 38829
(662) 728-3137
Mailing address
PO BOX 180, TISHOMINGO, MS 38873-0180
(662) 596-5594
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
91
MS
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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