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Individual

MARY LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12178 5A RD, PLYMOUTH, IN 46563-9767
(574) 286-7728
Mailing address
12178 5A RD, PLYMOUTH, IN 46563-9767
(574) 286-7728

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
25-018954-1
IN

Other

Enumeration date
06/16/2025
Last updated
06/16/2025
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