Wofford, Tyesha Shonta
Wofford, Tyesha Shonta is an sole proprietor health care provider with primary practice located at 2981 Kanell Blvd , Poplar Bluff MO 63901-4008. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Wofford, Tyesha Shonta can be contacted via phone (573) 712-2902.Contact Information
Primary practice address
2981 Kanell Blvd
Poplar Bluff MO 63901-4008
Phone: (573) 712-2902
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1578077749 |
|---|---|
| LBN Legal business name | Wofford, Tyesha Shonta |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 27th, 2017 |
| Last updated | Nov 27th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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