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Individual

RIEKETTA DANYELLE WILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2055 N KEYSTONE AVE, INDIANAPOLIS, IN 46218-3562
(317) 658-9315
Mailing address
2055 N KEYSTONE AVE, INDIANAPOLIS, IN 46218-3562
(317) 658-9315

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
20-015099-1
IN
3747P1801X
Personal Care Attendant
20-015099-1
IN
374U00000X
Home Health Aide
20-015099-1
IN
376J00000X
Homemaker
20-015099-1
IN

Other

Enumeration date
02/17/2021
Last updated
02/17/2021
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