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Individual

PATTY STALLWORTH

Active
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Individual

PATTY STALLWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CEO

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
347C00000X
AL
347C00000X
Private Vehicle
347C00000X
AL
374U00000X
Home Health Aide
Primary
374U00000X
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1326069964
VETERANS HOMEBOUND SERVICES
01
1679654966
VETERANS HOMEBOUND SERVICES
Enumeration date
04/25/2016
Last updated
06/20/2016
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