Individual
JAQUAILA CORRANN DOTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 WAKEFIELD AVE, YOUNGSTOWN, OH 44514-1060
(330) 775-6119
Mailing address
1501 WAKEFIELD AVE, YOUNGSTOWN, OH 44514-1060
(330) 775-6119
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
TD043829
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TD048329
—
OH
Enumeration date
10/01/2020
Last updated
10/01/2020
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