Individual
JESSICA HILDA TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11600 NW 140TH PL, REDDICK, FL 32686
(352) 622-7038
Mailing address
PO BOX 412, LOWELL, FL 32663-0412
(352) 622-7038
Taxonomy
Speciality
Code
Description
License number
State
385HR2065X
Child Physical Disabilities Respite Care
Primary
235893
FL
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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