Individual
DEBRA A WALLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
911 RANDOLPH ST, DAYTON, OH 45417-3734
(440) 796-8819
Mailing address
911 RANDOLPH ST, DAYTON, OH 45417-3734
(440) 796-8819
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108413670299
—
OH
Enumeration date
01/25/2021
Last updated
01/25/2021
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