Healthcare Provider Details

I. General information

NPI: 1811766884
Provider Name (Legal Business Name): PATRICIA MONIQUE GOLDSMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 01/01/2024
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 S TERRACE AVE
COLUMBUS OH
43204-3247
US

IV. Provider business mailing address

179 S TERRACE AVE
COLUMBUS OH
43204-3247
US

V. Phone/Fax

Practice location:
  • Phone: 614-641-1186
  • Fax:
Mailing address:
  • Phone: 614-641-1186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: