Individual ProviderMadeline R DeshazerStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address9 Kenny Dr, Athens, OH 45701-9406(913) 271-4884(740) 593-0902PECOS EnrollmentBased on the most recent information from CMS, provider Madeline R Deshazer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1871267591Provider TypeIndividualFull NameDeshazer, Madeline RGenderFemaleSole ProprietorNoEnumeration Date8/5/2021Last Updated10/22/2024Contact InformationPractice LocationPractice Address9 Kenny Dr, Athens, OH 45701-9406Phone(913) 271-4884FaxUnlisted FaxMailing LocationMailing Address1 Ohio University Dept Of Psychology, Porter Hall Room 002, Athens, OH 45701-2942Phone(740) 593-0902Fax(740) 593-4790Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer