Individual
DESTA DEJENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2152 LEAH LN, REYNOLDSBURG, OH 43068-3518
(614) 599-1567
Mailing address
2152 LEAH LN, REYNOLDSBURG, OH 43068-3518
(614) 599-1567
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
3050031
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3050031
—
OH
Enumeration date
12/31/2014
Last updated
12/31/2014
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