Individual
MRS. TAISHA DEJESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9008 GRIERS PASTURE DR, CHARLOTTE, NC 28278-0050
(518) 331-4809
Mailing address
9008 GRIERS PASTURE DR, CHARLOTTE, NC 28278-0050
(518) 331-4809
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04641416
—
NY
Enumeration date
06/28/2017
Last updated
08/16/2022
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