Healthcare Provider Details

I. General information

NPI: 1962618595
Provider Name (Legal Business Name): KATHERINE GUESMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 GOODLAND DR
HUDSON OH
44236-3931
US

IV. Provider business mailing address

6600 ALPHA DR APT 229
KENT OH
44240-4132
US

V. Phone/Fax

Practice location:
  • Phone: 330-656-5126
  • Fax:
Mailing address:
  • Phone: 412-849-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: