Individual
BLAISE DILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1044 S COLUMBUS ST, XENIA, OH 45385-9641
(937) 684-6423
Mailing address
1044 S COLUMBUS ST, XENIA, OH 45385-9641
(937) 684-6423
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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