Individual
JULLIET ISANGE ELEM I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 N MAIN ST STE 530, DUNCANVILLE, TX 75116-3660
(817) 517-0216
Mailing address
550 N MAIN ST STE 530, DUNCANVILLE, TX 75116-3660
(817) 517-0216
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880820601
—
TX
Enumeration date
02/22/2022
Last updated
02/22/2022
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