Provider Demographics
NPI:1528637311
Name:MARLOWE-MCCRAY, TELISA D
Entity type:Individual
Prefix:
First Name:TELISA
Middle Name:D
Last Name:MARLOWE-MCCRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ESSENTIAL HOME HEALTH CARE SERVICES LLC
Mailing Address - Street 2:8078 NW MARTIN L. KING ROAD
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321
Mailing Address - Country:US
Mailing Address - Phone:850-447-1154
Mailing Address - Fax:
Practice Address - Street 1:ESSENTIAL HOME HEALTH CARE SERVICES LLC
Practice Address - Street 2:8078 NW MARTIN L. KING ROAD
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321
Practice Address - Country:US
Practice Address - Phone:850-447-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health