Theresa Marie Daugherty

Individual provider Active NPI Attendant Care Provider · West Jefferson, OH

NPI 1417580374 · NPPES record last updated Feb 19, 2020

Key facts

NPI
1417580374
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
430 Forrestwood Ave
West Jefferson, OH 43162-9552
Phone
(614) 354-7270
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Yes

Addresses

Primary practice location

430 Forrestwood Ave
West Jefferson, OH 43162-9552

Mailing address

430 Forrestwood Ave
West Jefferson, OH 43162-9552

Other providers in West Jefferson, OH

All providers in West Jefferson, OH · Attendant Care Provider in Ohio

Sources for this page

Verify at the official NPI Registry.