Provider Demographics
NPI:1023716230
Name:HASFORD, DEANNA LEIGH (LDO)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LEIGH
Last Name:HASFORD
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7680 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2340
Mailing Address - Country:US
Mailing Address - Phone:937-236-9640
Mailing Address - Fax:937-236-9657
Practice Address - Street 1:7680 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-2340
Practice Address - Country:US
Practice Address - Phone:937-236-9640
Practice Address - Fax:937-236-9657
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.005731-SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician