Individual
MISS CAMISHA LOUISE MAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2124 AUBURN AVE, DAYTON, OH 45406-2912
(937) 367-1547
Mailing address
2124 AUBURN AVE, DAYTON, OH 45406-2912
(937) 367-1547
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN112204
OH
Other
Enumeration date
09/19/2007
Last updated
06/27/2008
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