Individual
DEANNA A MABRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
2109 SUPERIOR AVE, SPRINGFIELD, OH 45505-4741
(937) 624-9376
Mailing address
2109 SUPERIOR AVE, SPRINGFIELD, OH 45505-4741
(937) 624-9376
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400537540906
OH
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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