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Individual

MRS. TAYELL LEFTRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CHW

Contact information

Practice address
2600 ROOSEVELT RD STE 200-6, VALPARAISO, IN 46383-0971
(219) 615-0095
Mailing address
2600 ROOSEVELT RD STE 200-6, VALPARAISO, IN 46383-0971
(219) 615-0095

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300007737
IN
Enumeration date
08/13/2021
Last updated
08/13/2021
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