Individual
ALICESON J STOUDMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
536 SAYBOLT AVE, WOOSTER, OH 44691-3445
(330) 317-5576
Mailing address
536 SAYBOLT AVE, WOOSTER, OH 44691-3445
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057331
—
OH
Enumeration date
07/23/2012
Last updated
07/23/2012
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