Provider Demographics
NPI:1043917925
Name:ASAMOAH, BILLIE JO E
Entity Type:Individual
Prefix:
First Name:BILLIE JO
Middle Name:E
Last Name:ASAMOAH
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 1:4235 E BROAD ST APT 18
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1234
Mailing Address - Country:US
Mailing Address - Phone:614-394-1888
Mailing Address - Fax:
Practice Address - Street 1:4235 E BROAD ST APT 18
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-1234
Practice Address - Country:US
Practice Address - Phone:614-394-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000000171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator