Individual
MISS CELESTE ANGELINA SANTIVASCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 DUBLIN CENTER DR, DUBLIN, OH 43017-5077
(614) 253-6933
Mailing address
186 E 13TH AVE, COLUMBUS, OH 43201-1810
(330) 410-6731
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
990403055739
MEDICAL MUTUAL
OH
Enumeration date
04/04/2018
Last updated
04/04/2018
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