Individual
SOCCORRI LAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6044 LITTLE BROOK CIR N APT 105, MEMPHIS, TN 38115-8307
(901) 212-9223
Mailing address
6044 LITTLE BROOK CIR N APT 105, MEMPHIS, TN 38115-8307
(901) 212-9223
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1000000029606
TN
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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