Individual
TACQUORA LASHAE MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA,CNA
Contact information
Practice address
2882 CHURCH ST, EAST POINT, GA 30344-3254
(404) 692-8860
Mailing address
2882 CHURCH ST, EAST POINT, GA 30344-3254
(404) 692-8860
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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