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1679297436
SHASTA PICKENS
HATTIESBURG, MS
NPI
1679297436
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MS 907223)
Enumeration Date
2022-09-26
Last Update Date
2022-10-06
Business Address
SHASTA PICKENS
3215 MONTAGUE BLVD
HATTIESBURG, MS 39406-9045
Phone number: 601-266-5454
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Mailing Address
SHASTA PICKENS
841 COUNTY ROAD 9
BAY SPRINGS, MS 39422-9045
Phone number: 601-670-0389
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