# MAPLE TREE CANCER ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992225148
- **Authorized official:** DR. KAREN Y WONDERS PH.D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (937) 477-8213

## Contact information

- **Practice address:** 3535 PENTAGON BLVD, BEAVERCREEK, OH 45431-1705
- **Practice address phone:** (937) 477-8213
- **Mailing address:** 425 N FINDLAY ST, DAYTON, OH 45404-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Y00000X | Clinical Exercise Physiologist | — | NULL | Yes |
| 224Y00000X | Clinical Exercise Physiologist | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/20/2017
- **Last updated:** 04/09/2018