| NPI | 1437612801 |
|---|---|
| Former Name | REVA LATISHA MATTHIEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-01-13 |