Individual
MRS. LENA DANIELLE CLOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
GENOA HEALTHCARE LLC, 8555 TAFT STREET, MERRILLVILLE, IN 46410
(219) 769-8171
(219) 769-8176
Mailing address
12806 FAWN CT, CEDAR LAKE, IN 46303-8675
(219) 771-0102
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022500A
IN
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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