Individual
DEZIRAE K ALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
601 S EDWIN C MOSES BLVD, NW BLDG., 4TH FLOOR, DAYTON, OH 45417-3424
(937) 734-8333
(937) 734-8339
Mailing address
601 S EDWIN C MOSES BLVD, NW BLDG., 4TH FLOOR, DAYTON, OH 45417-3424
(937) 734-8333
(937) 734-8339
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1000608
OH
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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