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Maquia Massirie Hall-booth, LPN
Child Physical Disabilities Respite Care in Clarksville, Tennessee
NPI 1871050104

Maquia Massirie Hall-booth is a Child Physical Disabilities Respite Care based in Clarksville, TN and is specialized in Respite Care, Physical Disabilities, Child. Maquia Massirie Hall-booth practices in Clarksville, TN and has the professional credentials of LPN. The NPI Number for Maquia Massirie Hall-booth is 1871050104 and holds a License No. 0219037 (Tennessee).

The current practice location address for Maquia Massirie Hall-booth is 3129 Westchester Dr, Clarksville, TN and can be reached out via phone at 708-359-5472.

Location: 3129 Westchester Dr, Clarksville, TN, 37043-3804
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871050104
Provider Name
Maquia Massirie Hall-booth
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
3129 Westchester Dr, Clarksville, TN, 37043-3804
Phone Number
708-359-5472
Fax Number
Provider Enumeration Date
02/22/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPN0000091074 01 TN NURSING LICENSE
institution
Provider Business Practice Location Address Details
Address
3129 Westchester Dr
City
Clarksville
State
Tennessee
Zip
37043-3804
Phone Number
708-359-5472
Fax Number
person
Provider Business Mailing Address Details
Address
3129 Westchester Dr
City
Clarksville
State
Tennessee
Zip
37043-3804
Phone Number
708-359-5472
Fax Number
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Physical Disabilities, Child
Taxonomy
385HR2065X
License No.
0219037 (Tennessee)
Definition
A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers.
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