Individual
TIFFANY THERESA DEBENEDITTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5307 ELENA WAY, WOODSTOCK, GA 30188-7869
(239) 443-9581
Mailing address
5307 ELENA WAY, WOODSTOCK, GA 30188-7869
(239) 443-9581
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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