Healthcare Provider Details
I. General information
NPI: 1215650262
Provider Name (Legal Business Name): CAROL DRIVER NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2949 COUNTY ROAD 24
CARDINGTON OH
43315-9222
US
IV. Provider business mailing address
2949 COUNTY ROAD 24
CARDINGTON OH
43315-9222
US
V. Phone/Fax
- Phone: 614-448-7629
- Fax:
- Phone: 614-448-7629
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: