Provider Demographics
NPI:1962090605
Name:VELEZ-DOUGLAS EL, DREWCILLA GINA
Entity type:Individual
Prefix:
First Name:DREWCILLA
Middle Name:GINA
Last Name:VELEZ-DOUGLAS EL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6423 ROSSMORE LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8759
Mailing Address - Country:US
Mailing Address - Phone:614-743-0115
Mailing Address - Fax:
Practice Address - Street 1:6423 ROSSMORE LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8759
Practice Address - Country:US
Practice Address - Phone:614-743-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021986225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist