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Individual

JALA RAQUEL BENTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1536 CRAYTON AVE, LIMA, OH 45805-3722
(419) 371-6054
Mailing address
640 E 4TH ST, LIMA, OH 45804-2512
(419) 371-6054

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
OH

Other

Enumeration date
04/19/2021
Last updated
04/19/2021
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