Individual
SASHA LEE B WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6412 N UNIVERSITY DR STE 114, TAMARAC, FL 33321-4002
(954) 726-6722
Mailing address
6412 N UNIVERSITY DR STE 114, TAMARAC, FL 33321-4002
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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