Individual
LATASHA LASHAE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
341 EDGEWOOD TERRACE DR, JACKSON, MS 39206-6217
(601) 486-7344
Mailing address
341 EDGEWOOD TERRACE DR, JACKSON, MS 39206-6217
(601) 486-7344
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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