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Individual

LAVON M. BENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
417 N DEFIANCE ST, STRYKER, OH 43557-9472
(419) 344-5118
Mailing address
417 N DEFIANCE ST # 544, STRYKER, OH 43557-9472
(419) 344-5118

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
347C00000X
Private Vehicle
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
09/28/2023
Last updated
09/28/2023
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