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Individual
LISA ANN MINOR
Active
Individual
LISA ANN MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
3810028489
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810028489
PROVIDER ID
WV
Enumeration date
10/23/2017
Last updated
10/23/2017
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