Individual
TABITHA VACHUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W BROADWAY AVE, SUITE # 160, MINNEAPOLIS, MN 55411-2572
(612) 353-6308
(612) 886-2708
Mailing address
1200 W BROADWAY AVE, SUITE # 160, MINNEAPOLIS, MN 55411-2572
(612) 353-6308
(612) 886-2708
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
47-2951436
MN
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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