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General NPI Number Information
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NPI Number | 1184053191
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Entity Type | Organization
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Legal Business Name | MARY MUEMA
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Dates
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Enumeration Date | 11/11/2013
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Last Update Date | 11/11/2013
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Provider Practice Location Address
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Address Line | 1912 RADNOR AVE
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City | COLUMBUS
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State | OH
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Zip | 43224-2217
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Country | US
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Telephone | 614-314-7651
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 RADNOR AVE
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City | COLUMBUS
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State | OH
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Zip | 43224-2217
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Country | US
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Telephone | 614-314-7651
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Fax |
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Authorized Official
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Title or Position | DIRECT PERSONAL CARE
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Name | MRS. MARY MUMBI MUEMA
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Credential |
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Telephone | 614-314-7651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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