Most Relevant Information
Provider Data
| NPI Number: | 1003523861 |
| Provider Name: | CAROLINE GRACE FERGUSON |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/01/2022 |
| Last Updated: | 11/01/2022 |
Provider Practice Location
141 W 3RD ST
DAYTON
OH
454021814
Practice Location Phone/Fax
| Phone: | 9374615550 |
| Fax: |
Provider Mailing Location
141 W 3RD ST
DAYTON
OH
454021814
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |