Hattie Lee Haralson

Individual provider Active NPI Homemaker · Benton, MS

NPI 1902300874 · NPPES record last updated Mar 23, 2018

Key facts

NPI
1902300874
Entity type
Individual (NPI type 1)
Primary specialty
Homemaker 376J00000X
Practice address
3825 Campbell Road
Benton, MS 39039
Phone
(662) 571-9302
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X Yes

Addresses

Primary practice location

3825 Campbell Road
Benton, MS 39039

Mailing address

3825 Campbell Road
Benton, MS 39039
Phone (662) 571-9302

Other providers in Benton, MS

All providers in Benton, MS · Homemaker in Mississippi

Sources for this page

Verify at the official NPI Registry.