Individual
AUDREY IDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11052 STRAYHORN DR, DALLAS, TX 75228-2449
(972) 698-0226
Mailing address
11052 STRAYHORN DR, DALLAS, TX 75228-2449
(972) 698-0226
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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