Individual
MISS TANISHA LA'SHAY SUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
143 CHESTNUT CROSSING DR APT H, NEWARK, DE 19713-3622
(215) 910-8361
Mailing address
143 CHESTNUT CROSSING DR APT H, NEWARK, DE 19713-3622
(215) 910-8361
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L2-0010742
DE
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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