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Individual

DONNA L CASALICCHIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3258 LOTZE LOOP, COEUR D ALENE, ID 83815-8546
(422) 223-0279
Mailing address
3258 LOTZE LOOP, COEUR D ALENE, ID 83815-8546
(425) 223-0279

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
08/06/2019
Last updated
08/06/2019
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