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Individual
TAMMY HAVENS
Active
Individual
TAMMY HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
253Z00000X
In Home Supportive Care Agency
—
—
376J00000X
Homemaker
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
362668491189E
STNA
OH
Enumeration date
06/09/2023
Last updated
06/09/2023
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