Individual
MRS. TYESHA WOLVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1035 SUSIE B RUFFIN AVE, LAUREL, MS 39440-3082
(601) 689-4443
Mailing address
1035 SUSIE B RUFFIN AVE, LAUREL, MS 39440-3082
(601) 689-4443
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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