Individual
MRS. MICHELINE RENEE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10008 CARLOWAY HILLS DR., WIMAUMA, FL 33598
(813) 605-5555
Mailing address
10008 CARLOWAY HILLS DR., WIMAUMA, FL 33598
(813) 605-5555
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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