Individual
DETRA ANTOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 7TH AVE, AKRON, OH 44306-2153
(330) 203-4283
Mailing address
1201 7TH AVE, AKRON, OH 44306-2153
(330) 203-4283
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
401789520915
OH
376J00000X
Homemaker
401789520915
OH
376K00000X
Nurse's Aide
Primary
401789520915
OH
Other
Enumeration date
02/09/2016
Last updated
01/28/2021
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