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1619707676
SHELLY MAE LUMMUS
EMMETT, ID
NPI
1619707676
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
(Licence: OR THW000111135)
Enumeration Date
2024-08-05
Last Update Date
2024-08-05
Business Address
SHELLY MAE LUMMUS
207 E 12TH ST
EMMETT, ID 83617-3626
Phone number: 208-365-1065
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Mailing Address
SHELLY MAE LUMMUS
207 E 12TH ST
EMMETT, ID 83617-3626
Phone number: 208-365-1065
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