Individual
TAHIRA BURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1412 N BOUVIER ST, PHILADELPHIA, PA 19121-4215
(215) 901-3203
Mailing address
1437 CARRICK CT, MIDDLETOWN, DE 19709-9970
(215) 901-3203
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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