Individual provider · NPI-1

Connie S Anderson

Technician, Attendant Care Provider · Dayton, OH

NPI number1750977062
StatusActive
Last updated in NPPESDec 21, 2020

Details

NPI
1750977062
Entity type
Individual (NPI-1)
Name
Miss Connie S Anderson
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 21, 2020
Certification date
Dec 21, 2020
Last updated
Dec 21, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3747A0650X Technician, Attendant Care Provider––Yes

Practice location

9525 E Haskett Ln
Dayton, OH 45424-1611

Phone 937-232-2572

Mailing address

9525 E Haskett Ln
Dayton, OH 45424-1611

Phone 937-232-2572

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