Latasha Peavy, IDD WAIVER SERVICES
NPI #1184340135 in Columbia, Mississippi
Provider Information
- NPI Number
- 1184340135
- Entity Type
- Individual
- Name
- Latasha Peavy, IDD WAIVER SERVICES
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Day Training/Habilitation Specialist
- Credential
- IDD WAIVER SERVICES
- Enumeration Date
- Oct 12, 2022
- Last Updated
- Oct 12, 2022
Practice Location
- Address
- 1104 BROAD ST
- City
- Columbia
- State
- Mississippi
- ZIP Code
- 39429-3112
- Phone
- (601) 736-0996
Specialties & Taxonomy Codes
| Specialty |
|---|
| Day Training/Habilitation Specialist |
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