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General NPI Number Information
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NPI Number | 1225358500
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Entity Type | Organization
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Legal Business Name | PLATINUM SELECT STAFFING
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 1737 E FRANKFORD RD APT 1404
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City | CARROLLTON
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State | TX
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Zip | 75007-5630
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Country | US
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Telephone | 404-630-8188
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Fax |
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Provider Business Mailing Address
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Address Line | 1737 E FRANKFORD RD APT 1404
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City | CARROLLTON
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State | TX
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Zip | 75007-5630
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Country | US
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Telephone | 404-630-8188
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MISS SANDRA DELORES DILWORTH
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Credential | MS, CCC-SLP
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Telephone | 404-630-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 102217
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License Number State | TX
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