Individual
EVA SPEAKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 E MAIN ST, LEESBURG, OH 45135-9660
(937) 780-1081
Mailing address
208 E MAIN ST, LEESBURG, OH 45135-9660
(937) 780-2082
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
3004386
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3004386
OHIO FAMILY JOB AND SERVICES - MY CARE OHIO
OH
Enumeration date
07/28/2014
Last updated
07/28/2014
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