LATESAH ROSHA BURKS LCSW
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1700620960- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LCSW
- Status
- Active
Contact & Location
- Address
- 105 EXECUTIVE DR, MADISON, MS, 391108496
- Phone
- (601) 258-0818
Specialties & Taxonomies
Social Worker, Clinical
Primary License: MS #C11093