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Individual

PEBBLES JANNELL TANARUNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 UNIVERSITY OAKS BLVD APT J103, COLLEGE STATION, TX 77840-3472
(210) 701-1708
Mailing address
600 UNIVERSITY OAKS BLVD APT J103, COLLEGE STATION, TX 77840-3472
(210) 701-1708

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker

Other

Enumeration date
07/02/2020
Last updated
07/02/2020
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