Individual
JESSICA D ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 VALLEY OAK CT, ENGLEWOOD, OH 45415-1372
(937) 829-3675
Mailing address
521 VALLEY OAK CT, ENGLEWOOD, OH 45415-1372
(937) 829-3675
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401326911211
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401326911211
—
OH
Enumeration date
07/24/2019
Last updated
07/24/2019
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