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1578108627
AUTUM MARIE MALLICK
HOLT, FL
NPI
1578108627
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747A0650X Technician Attendant Care Provider
Additional Taxonomies
372500000X Chore Provider
Enumeration Date
2019-11-13
Last Update Date
2019-11-14
Business Address
AUTUM MARIE MALLICK
7165 TEE DON CT
HOLT, FL 32564-8925
Phone number: 850-313-9846
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Mailing Address
AUTUM MARIE MALLICK
7165 TEE DON CT
HOLT, FL 32564-8925
Phone number: 850-313-9846
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