Individual
MRS. SISSERITTA RENEE DEMPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
524 SW PINCKNEY ST, MADISON, FL 32340-1964
(850) 973-7966
Mailing address
524 SW PINCKNEY ST, MADISON, FL 32340-1964
(850) 973-7966
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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