Individual
MISS MIHOLLY PRIMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 BROOKSIDE DR APT B, CLIFTON, NJ 07012-6327
(201) 960-8863
Mailing address
15 BROOKSIDE DR APT B, CLIFTON, NJ 07012-6327
(201) 960-8863
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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