Individual
LARISSA WOOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12555 ORANGE DR STE 222, DAVIE, FL 33330-4304
(954) 862-1707
Mailing address
1501 NW 94TH AVE, PEMBROKE PINES, FL 33024-4504
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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