Individual
ARETHA FRANKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12611 RIO NUECES LN, ROSHARON, TX 77583-4086
(281) 676-9877
Mailing address
12611 RIO NUECES LN, ROSHARON, TX 77583-4086
(281) 676-9877
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
14589968
TX
175T00000X
Peer Specialist
Primary
1475-0421
TX
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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