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Individual

DACHIA GIPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1789 ALCOY DR., COLUMBUS, OH 43227
(614) 432-6747
Mailing address
1789 ALCOY DR, COLUMBUS, OH 43227-3313
(614) 432-6747

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
401646780514
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
401646780514
STNA
OH
Enumeration date
06/18/2014
Last updated
06/18/2014
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