Individual
MRS. BESSIE MODUPE FAYOMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., B.S.N
Contact information
Practice address
3519 RED MINE LN, GRAND PRAIRIE, TX 75052-8800
(972) 522-0772
Mailing address
3519 RED MINE LN, GRAND PRAIRIE, TX 75052-8800
(972) 522-0772
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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