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Individual

MS. CAROLYN DENISE GAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
1600 MARS HILL DR APT B, WEST CARROLLTON, OH 45449-3128
(937) 287-4482
Mailing address
1600 MARS HILL DR APT B, WEST CARROLLTON, OH 45449-3128
(937) 287-4482

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
376954841197
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
376954841197
STATE OF OHIO NURSE AIDE REGISTRY
OH
Enumeration date
07/17/2012
Last updated
07/17/2012
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