Individual
IVY BAISIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6855 HIGHWAY 16 STE 102, SENOIA, GA 30276-8604
(678) 876-2724
Mailing address
55 ELLABELLE CT, SENOIA, GA 30276-6203
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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