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General NPI Number Information
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NPI Number | 1215745328
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Entity Type | Organization
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Legal Business Name | NAFRESHA ABUAUN PRIVATE PRACTICE LLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 2555 S DIXIE DR STE 201
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City | DAYTON
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State | OH
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Zip | 45409-1532
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Country | US
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Telephone | 937-835-4901
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Fax | 937-848-1535
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Provider Business Mailing Address
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Address Line | 17 STANTON DR
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City | SPRINGBORO
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State | OH
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Zip | 45066-8632
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Country | US
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Telephone | 937-835-4901
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Fax | 937-848-1535
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Authorized Official
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Title or Position | OWNER
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Name | NAFRESHA ABUAUN
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Credential |
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Telephone | 937-835-4901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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