Ludivia Mae Blossom
In Home Supportive Care in Whitehouse, OH. Individual provider (NPI-1).
NPI number1689302002
StatusActive
Last updated in NPPESAug 12, 2022
Details
- NPI
- 1689302002
- Entity type
- Individual (NPI-1)
- Name
- Ludivia Mae Blossom
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 12, 2022
- Certification date
- Aug 12, 2022
- Last updated
- Aug 12, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Practice location
7700 Jeffers RdWhitehouse, OH 43571-9822
Phone 419-509-7056
Mailing address
7700 Jeffers RdWhitehouse, OH 43571-9822
Phone 419-509-7056
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