Individual
MRS. CASSANDRA DETTWILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
850 NELLIE ST, GREENFIELD, OH 45123-1567
(937) 981-2165
Mailing address
9211 SNAKE RD, GREENFIELD, OH 45123-9593
(937) 661-4919
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
04249
OH
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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