Individual
DAIRRA ANISE BOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3373 DUNSTAN DR NW, WARREN, OH 44485-1526
(330) 321-9148
Mailing address
3373 DUNSTAN DR NW, WARREN, OH 44485-1526
(330) 321-9148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
133617-M-IV
OH
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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