Individual
ANGEL LYNN DEFORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 E MAIN ST, WHITEHALL, OH 43213-3593
(614) 334-6903
Mailing address
140 E TOWN ST STE 1450, COLUMBUS, OH 43215-6601
(614) 639-6590
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005933
OH
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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