Healthcare Provider Details

I. General information

NPI: 1215888110
Provider Name (Legal Business Name): ROCHERVIE EDWIGE MABIDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/15/2026
Certification Date: 02/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 LAKEBEND DR
DAYTON OH
45404-2135
US

IV. Provider business mailing address

3844 LAKEBEND DR
DAYTON OH
45404-2135
US

V. Phone/Fax

Practice location:
  • Phone: 937-830-2711
  • Fax:
Mailing address:
  • Phone: 937-830-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: