Individual
CHANCELINE TENGOMOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 S TIMBER HOLLOW DR APT 413, FAIRFIELD, OH 45014-7824
(402) 601-4728
Mailing address
4 S TIMBER HOLLOW DR APT 413, FAIRFIELD, OH 45014-7824
(402) 601-4728
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
181030
OH
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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