MEDICARE: DARIA LOVE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1164098273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIA LOVE

Provider Business Mailing Address
First Line	:	4125 FLEETWOOD DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45416-2134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4125 FLEETWOOD DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45416-2134
Country	:	US
Telephone Number	:	937-510-5330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2021
Last Update Date	:	05/29/2021

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Directions to “ DARIA LOVE ” Practice Location

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