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1003410408
TISHA DAWN MALLOW
BUCKHANNON, WV
NPI
1003410408
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Additional Taxonomies
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-11-25
Last Update Date
2023-10-02
Business Address
TISHA DAWN MALLOW
8 N SPRING ST
BUCKHANNON, WV 26201-2720
Phone number: 304-472-0395
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Mailing Address
TISHA DAWN MALLOW
101 CABOOSE DRIVE
HARMAN, WV 26270
Phone number: 304-704-5479
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