Individual
DEENA MEDDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1827 WOODMAN CENTER DR, KETTERING, OH 45420-1157
(937) 558-3408
Mailing address
1827 WOODMAN CENTER DR, KETTERING, OH 45420-1157
(937) 558-3408
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.180033
OH
183700000X
Pharmacy Technician
Primary
09307313
OH
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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