| NPI | 1770075509 |
|---|---|
| Former Name | THERESA JOLLEY-COUNCIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 172A00000X Driver |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-06-11 |