Individual
LATONYA HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 BRISTOL BLVD, JACKSON, MS 39204-3506
(662) 590-3325
Mailing address
125 BRISTOL BLVD, JACKSON, MS 39204-3506
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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