Individual
KISTRICIA BREYANNA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1815 CENTRAL PARK RD APT F10, CHARLESTON, SC 29412-2807
(843) 925-2995
Mailing address
1815 CENTRAL PARK RD APT F10, CHARLESTON, SC 29412-2807
(843) 925-2995
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
5899646
SC
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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