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Individual

DEBBIE KETSIA LAURENCEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6910 TORRESDALE AVE, PHILADELPHIA, PA 19135-1906
(215) 335-7000
(215) 335-9000
Mailing address
6910 TORRESDALE AVE, PHILADELPHIA, PA 19135-1906
(215) 335-9000
(215) 335-7000

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1035409590001
PA
01
103540959001
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES
PA
Enumeration date
12/21/2018
Last updated
12/21/2018
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