Individual
SHAKIRA WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 ARCH STREET, PHILADELPHIA, PA 19104
(215) 872-0138
Mailing address
2612 E MADISON ST, PHILADELPHIA, PA 19134-5202
(215) 385-6270
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
PA
253Z00000X
In Home Supportive Care Agency
—
PA
332U00000X
Home Delivered Meals
—
PA
372600000X
Adult Companion
—
PA
376K00000X
Nurse's Aide
10012712
PA
Other
Enumeration date
01/05/2020
Last updated
01/05/2020
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