Individual
MRS. CASSANDRA L WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6162 TEAGARDEN CIR, DAYTON, OH 45449-3014
(937) 951-9987
Mailing address
6162 TEAGARDEN CIR, DAYTON, OH 45449-3014
(937) 951-9987
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
164301
OH
164W00000X
Licensed Practical Nurse
Primary
LPN.164302
OH
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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