NPI | 1477142073 |
---|---|
Former Name | RACHELLE HACOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225700000X Massage Therapist (Licence: AL 5561) |
Additional Taxonomies | 251E00000X Home Health (Licence: CA 00991701) |
374U00000X Home Health Aide (Licence: CA 00991701) | |
Enumeration Date | 2021-01-18 |
Last Update Date | 2021-01-18 |