Individual
CHANCENIA RAESHELLE CLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
96 PINEWOOD DR, COLUMBUS, OH 43213-1249
(614) 902-6955
Mailing address
96 PINEWOOD DR, COLUMBUS, OH 43213-1249
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.169039.MEDS-IV
OH
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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