Individual
KATHRYN SUE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3316 PERCENTUM RD APT 311, TOLEDO, OH 43617-2141
(419) 283-3260
Mailing address
3316 PERCENTUM RD APT 311, TOLEDO, OH 43617-2141
(419) 283-3260
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
4808328
OH
3747P1801X
Personal Care Attendant
Primary
4808328
OH
376J00000X
Homemaker
4808328
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013893
—
OH
01
—
4808328
ODM
OH
Enumeration date
09/14/2020
Last updated
09/15/2020
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