Healthcare Provider Details

I. General information

NPI: 1609478593
Provider Name (Legal Business Name): ADALINA DAWN BRANDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2020
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 CHICKORY AVE
COLUMBUS OH
43230-1009
US

IV. Provider business mailing address

3890 CHICKORY AVE
COLUMBUS OH
43230-1009
US

V. Phone/Fax

Practice location:
  • Phone: 614-315-2123
  • Fax:
Mailing address:
  • Phone: 614-315-2123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: