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Individual

MRS. CRYSTAL GAYEL SHAFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IP

Contact information

Practice address
39351 CENTER AVE, 39351 CENTER AVENUE, LISBON, OH 44432-9604
(330) 429-2485
Mailing address
39351 CENTER AVE, 39351 CENTER AVENUE, LISBON, OH 44432-9604
(330) 429-2485

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2917491
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2917491
OH
Enumeration date
04/02/2009
Last updated
06/08/2009
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