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Individual

THEMBALENA HASAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7607 WILDBRANCH RD, HAMILTON, OH 45011-7780
(513) 714-4466
Mailing address
7607 WILDBRANCH RD, HAMILTON, OH 45011-7780
(513) 714-4466

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
501093610406
OH
376K00000X
Nurse's Aide
Primary
5010936106
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3101161
STATE OF OHIO PROVIDER NUMBER
OH
Enumeration date
07/08/2014
Last updated
07/08/2014
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