Individual
GAURAKISORA RADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 HOSPITAL DR, ATHENS, OH 45701-2301
(740) 773-4366
Mailing address
PO BOX 188, CHILLICOTHE, OH 45601-0188
(740) 773-4366
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
07/24/2023
Last updated
06/27/2024
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