Organization
LAUREL G KAISER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN GARLAND (CREDENTIALING AGENT)
(404) 213-5329
Entity
Organization
Contact information
Practice address
25201 CHAGRIN BLVD STE 390, BEACHWOOD, OH 44122-5637
(216) 282-7244
Mailing address
5277 GOLFWAY LN, LYNDHURST, OH 44124-3735
(216) 282-7244
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912299306
INDIVIDUAL NPI
OH
Enumeration date
09/01/2020
Last updated
01/27/2021
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