Individual
SHAVONTIA SHARROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
661 HIGHLAND AVE, MANSFIELD, OH 44903
(419) 560-1168
Mailing address
1421 LEXINGTON AVE # 268, MANSFIELD, OH 44907-2629
(419) 560-1168
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
OH
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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