Individual
DE'AIRRA DIANE REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4497 BUFORT BLVD, HUBER HEIGHTS, OH 45424-5582
(937) 877-9171
Mailing address
4497 BUFORT BLVD, HUBER HEIGHTS, OH 45424-5582
(937) 877-9171
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
VM177340
OH
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
VM177340
OH
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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