IndividualActive
Porosha Gaines, IDD WAIVER SERVICES
NPI 1386369726 · Day Training/Habilitation Specialist · Ellisville, MS
Provider details
- NPI number
- 1386369726
- Entity type
- Individual
- Primary specialty
- Day Training/Habilitation SpecialistNursing Service Related Providers
- Credential
- IDD WAIVER SERVICES
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Nursing Service Related Providers
Practice location
106 Mize St Apt 26
Ellisville, MS 39437-2067
Phone: (601) 800-8564
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 18679
Hattiesburg, MS 39404-8679
Registry dates
- Enumerated
- 2022-10-07
- Last updated
- 2022-10-07
- Certified
- 2022-10-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.