Individual
MRS. MARYLAILA D SUSAINATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
435 KREIDER DR, FAIRBORN, OH 45324-2160
(314) 324-4698
Mailing address
435 KREIDER DR, FAIRBORN, OH 45324-2160
(314) 324-4698
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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