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Individual
WANDA S MASSIE
Active
Individual
WANDA S MASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100750
—
OH
Enumeration date
10/19/2020
Last updated
10/19/2020
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