Individual
MARCELLINE MAFOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 SAN REMO DR, MANSFIELD, TX 76063-8642
(678) 622-1415
Mailing address
4800 SAN REMO DR, MANSFIELD, TX 76063-8642
(678) 622-1415
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
352612
TX
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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