Tisha Dawn Mallow

NPI #1003410408 in Buckhannon, West Virginia

Provider Information

NPI Number: 1003410408
Entity Type: Individual
Name: Tisha Dawn Mallow
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Homemaker
Enumeration Date: Nov 25, 2020
Last Updated: Oct 2, 2023

Practice Location

Address: 8 N SPRING ST
City: Buckhannon
State: West Virginia
ZIP Code: 26201-2720
Phone: (304) 472-0395

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician - Personal Care Attendant — Personal Care Attendant	3747P1801X
Homemaker	376J00000X	Primary

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