Healthcare Provider Details
I. General information
NPI: 1861271884
Provider Name (Legal Business Name): AOUAOUCHE DALI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3347 STONEMASON WAY
COLUMBUS OH
43221-1962
US
IV. Provider business mailing address
3347 STONEMASON WAY
COLUMBUS OH
43221-1962
US
V. Phone/Fax
- Phone: 614-440-1909
- Fax:
- Phone: 614-440-1909
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: