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Individual

GWENDOLYN HOPE BRODESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
314 1/2 EAST THIRD ST, PIKETON, OH 45661
(740) 708-3480
Mailing address
314 1/2 EAST THIRD ST., PIKETON, OH 45661
(740) 708-3480

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
0058859
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0058859
OH
Enumeration date
10/25/2023
Last updated
10/25/2023
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