Provider Demographics
NPI:1548571003
Name:DIALLO, RAQUEL NICOLE (CNA)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:NICOLE
Last Name:DIALLO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 ZINSLE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-1917
Mailing Address - Country:US
Mailing Address - Phone:513-382-8189
Mailing Address - Fax:513-651-3911
Practice Address - Street 1:3731 ZINSLE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1917
Practice Address - Country:US
Practice Address - Phone:513-382-8189
Practice Address - Fax:513-651-3911
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide