Individual
FATIMA DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6548 N 17TH ST, PHILADELPHIA, PA 19126-3514
(814) 230-0026
Mailing address
6548 N 17TH ST, PHILADELPHIA, PA 19126-3514
(215) 868-1261
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
45993601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103798851
—
PA
Enumeration date
07/12/2019
Last updated
10/22/2020
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