Individual
METALISA JOYCE HARTFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2409 CHARBONEAU DR, WACO, TX 76710-1105
(254) 235-1969
Mailing address
2409 CHARBONEAU DR, WACO, TX 76710-1105
(254) 235-1969
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
15367
TX
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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