Individual
REBECCA S LIVENGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3445 BRIARDALE DR NW, MASSILLON, OH 44646-2812
(330) 605-9511
Mailing address
3445 BRIARDALE DR NW, MASSILLON, OH 44646-2812
(330) 605-9511
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RF378721
OH
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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