Healthcare Provider Details
I. General information
NPI: 1912665902
Provider Name (Legal Business Name): HOPE DREW BUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/07/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
807 E WASHINGTON ST STE 150
MEDINA OH
44256-3339
US
IV. Provider business mailing address
807 E WASHINGTON ST STE 150
MEDINA OH
44256-3339
US
V. Phone/Fax
- Phone: 330-241-4444
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: