MEDICARE: DEVYNNE HAUSER LSW

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	104100000X	Social Worker	S.2513054	OH
2	171M00000X	Case Manager/Care Coordinator	CDCA174490	OH

General Provider Information

NPI Number	:	1841880853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVYNNE HAUSER LSW

Provider Business Mailing Address
First Line	:	601 S EDWIN C MOSES BLVD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3424
Country	:	US
Telephone Number	:	937-734-8333
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 SOUTH EDWIN C MOSES BLVD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3424
Country	:	US
Telephone Number	:	937-734-8333
Fax Number	:

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

Provider Enumeration Date	:	01/23/2021
Last Update Date	:	03/19/2026

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