Individual
REBA DAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3830 WOODLEY RD STE C, TOLEDO, OH 43606-1177
(419) 841-1600
(419) 841-4181
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4299
(419) 473-3561
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0035495
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078904
—
OH
Enumeration date
05/20/2024
Last updated
12/05/2025
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