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Search › Ohio › 363LF0000X

Stawa Blanco

NPI 1073126314 · on the registry since 2020 · sole proprietor

Practice

Address
6121 Colerain Ave
Cincinnati, OH 45239
Phone
(513) 354-2466
Fax
(513) 906-5477
Organisation at this address
Dedicated Ohio Holding, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
363LF0000X
363LF0000X
Also registered as
363LF0000X
363LF0000X
Licence states on file
KY, WV, OH
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-12-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio