Individual
GWENDOLYN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2148 COUNTY ROAD 15, RAYLAND, OH 43943-7917
(740) 733-7209
Mailing address
2148 COUNTY ROAD 15, RAYLAND, OH 43943-7917
(740) 733-7209
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102768094999
—
OH
Enumeration date
05/11/2015
Last updated
05/11/2015
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