Individual
TYRELLE MAXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13642 HOUSE OF LANCASTER DR, BATON ROUGE, LA 70816-1119
(225) 803-8073
Mailing address
13642 HOUSE OF LANCASTER DR, BATON ROUGE, LA 70816-1119
(225) 803-8073
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
12/28/2021
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