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Individual

MRS. TARITA DOOLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
905 BALLARD ST SE, GRAND RAPIDS, MI 49507-2038
(616) 633-5354
Mailing address
905 BALLARD ST SE, GRAND RAPIDS, MI 49507-2038
(616) 633-5354

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
4703100135
MI
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
374U00000X
Home Health Aide
385H00000X
Respite Care

Other

Enumeration date
11/10/2020
Last updated
11/10/2020
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