Individual
MS. STEPHANIE L RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 PINE CONE DR, DAYTON, OH 45449-3037
(937) 998-7882
Mailing address
6330 PINE CONE DR, DAYTON, OH 45449-3037
(937) 998-7882
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498302
—
OH
Enumeration date
02/19/2020
Last updated
03/06/2020
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