Individual
SHANIQUO D HOLLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
444B BROAD ST, SUMTER, SC 29150-4157
(803) 607-5902
Mailing address
444B BROAD ST, SUMTER, SC 29150-4157
(803) 607-5902
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1HCP-1442
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86-1713828
—
SC
Enumeration date
11/09/2021
Last updated
11/09/2021
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