| Doctor Name: | MS. CAROLYN DENISE GAINES |
| NPI Number: | 1184979049 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | STNA |
| License Number: | 376954841197 |
| Business Practice Address: | 1600 Mars Hill Dr Apt B West Carrollton, OH - 454493128 |
| Business Phone Number: | 9372874482 |
| Business Fax Number: | |
| Mailing Address: | 1600 Mars Hill Dr Apt B, WEST CARROLLTON |
| State: | OH |
| Postal Code: | 454493128 |
| Phone Number: | 9372874482 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2012 |
| NPI Last Update Date: | 07/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | 376954841197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |