Individual
MRS. THERESA DENISE FAUNTLEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 BELLEVUE AVE APT 2, NORFOLK, VA 23509-1861
(757) 439-4418
Mailing address
2111 BELLEVUE AVE APT 2, NORFOLK, VA 23509-1861
(757) 439-4418
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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