Individual
MISS TASHEKIA GOWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17951 SELOVER RD, JAMAICA, NY 11434-3411
(347) 773-9533
Mailing address
17951 SELOVER RD, JAMAICA, NY 11434-3411
(347) 773-9533
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
270971-1
NY
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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