Individual
ISTAR HAGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4664 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 487-7805
Mailing address
4664 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 487-7805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
Y1469289
CA
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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