Individual
TYESHIA SWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 NE 7TH ST, OCALA, FL 34470-6332
(352) 843-9611
Mailing address
2701 NE 7TH ST, OCALA, FL 34470-6332
(352) 843-9611
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-5272815
—
FL
Enumeration date
03/14/2017
Last updated
03/14/2017
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