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1871247064
LORISSA DESHARRA BAKER
BRANDON, MS
NPI
1871247064
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2022-02-07
Last Update Date
2022-02-07
Business Address
LORISSA DESHARRA BAKER
613 MARQUETTE RD
BRANDON, MS 39042-3038
Phone number: 601-824-1692
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Mailing Address
LORISSA DESHARRA BAKER
PO BOX 88
BRANDON, MS 39043-0088
Phone number: 601-824-1692
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