Individual
SUEWAKO F KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6155 SIENNA TRL APT 708, BEAUMONT, TX 77708-4358
(409) 351-7598
Mailing address
6155 SIENNA TRL APT 708, BEAUMONT, TX 77708-4358
(409) 767-6446
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/17/2019
Last updated
03/17/2019
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