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General NPI Number Information
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NPI Number | 1750528550
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Entity Type | Organization
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Legal Business Name | WOMANLINE OF DAYTON, INC
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 301 E 6TH ST
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City | DAYTON
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State | OH
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Zip | 45402-2838
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Country | US
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Telephone | 937-223-3446
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Fax | 937-223-2384
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Provider Business Mailing Address
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Address Line | 301 E 6TH ST
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City | DAYTON
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State | OH
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Zip | 45402-2838
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Country | US
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Telephone | 937-223-3446
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Fax | 937-223-2384
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Authorized Official
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Title or Position | PRESIDENT/EXECUTIVE DIRECTOR
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Name | MR. JOHN THOMAS O'BRYAN
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Credential |
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Telephone | 937-223-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 636
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License Number State | OH
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