Individual
LAURA ANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1349 E 79TH ST, CLEVELAND, OH 44103-2864
(216) 302-5709
Mailing address
1349 E 79TH ST, CLEVELAND, OH 44103-2864
(216) 302-5709
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CL1011573
OH
Other
Enumeration date
03/20/2014
Last updated
02/10/2026
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