Individual
MRS. LORRENNA WALCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1812 RAVENNA AVE, LOUISVILLE, OH 44641-8983
(330) 875-5041
Mailing address
1812 RAVENNA AVE, LOUISVILLE, OH 44641-8983
(330) 875-5041
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7611100
—
OH
Enumeration date
09/11/2020
Last updated
09/11/2020
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