Individual
IEAISHA SHAVETTE GARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1406 VERMONT, LANCASTER, TX 75134
(757) 576-2962
Mailing address
1406 VERMONT, LANCASTER, TX 75134
(757) 576-2962
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
3747A0650X
TX
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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