Individual
MS. CHARRISSA JANE LABORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 NW MAIN ST STE 5, ENNIS, TX 75119-4079
(214) 608-7373
Mailing address
109 NW MAIN ST, ENNIS, TX 75119-4079
(214) 608-7373
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171R00000X
Interpreter
—
—
172A00000X
Driver
—
—
172M00000X
Mechanotherapist
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2020
Last updated
04/21/2020
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