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Individual

KATHY SHOEMAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10585 BRIAR RD, CENTERBURG, OH 43011-8463
(740) 272-3592
Mailing address
10585 BRIAR RD, CENTERBURG, OH 43011-8463
(740) 272-3592

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0124976
OH
01
2100596
PERSONAL CARE AIDE MRDD
OH
Enumeration date
05/04/2007
Last updated
07/08/2007
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