DETRA LA'QUEL HUMPHRIES

JACKSON, MS
NPI1033805569
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: MS  R865122)
Enumeration Date2023-04-17
Last Update Date2023-04-17
Business Address
Ms. DETRA LA'QUEL HUMPHRIES RN
1935 LAKELAND DR STE 900
JACKSON, MS 39216-5028
Phone number: 601-718-2487
Mailing Address
Ms. DETRA LA'QUEL HUMPHRIES RN
1935 LAKELAND DR STE 900
JACKSON, MS 39216-5028
Phone number: 601-718-2487
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