Individual
DAHYOJENDAYI L FULLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3236 LANDMARK DR STE 121, NORTH CHARLESTON, SC 29418-8490
(866) 491-1636
(843) 737-4896
Mailing address
7620 RIVERS AVE, SUITE 370 PMB#155, NORTH CHARLESTON, SC 29406-5008
(866) 491-1636
(843) 737-4896
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
IHCP-1297
SC
372600000X
Adult Companion
IHCP-1297
SC
373H00000X
Day Training/Habilitation Specialist
IHCP-1297
SC
374U00000X
Home Health Aide
IHCP-1297
SC
376K00000X
Nurse's Aide
IHCP-1297
SC
385H00000X
Respite Care
IHCP-1297
SC
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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