Individual
BIANCA M REDWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 GASCHO DR, DAYTON, OH 45410-3305
(937) 252-7500
(937) 252-8654
Mailing address
11 W MONUMENT AVE FL 7, DAYTON, OH 45402-1274
(937) 461-4300
(937) 461-0443
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326012360
—
OH
Enumeration date
10/30/2020
Last updated
10/30/2020
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