Individual
TIESHQUANNA CIARE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 KILGO ST, CLAYTON, NC 27520-1651
(919) 809-0852
Mailing address
PO BOX 94, CLAYTON, NC 27528-0094
(919) 809-0852
(844) 246-5039
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
NC
343900000X
Non-emergency Medical Transport (VAN)
—
NC
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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