Individual
LA SHANDA D WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3388 E 121ST ST, CLEVELAND, OH 44120-4302
(216) 526-3036
Mailing address
3388 E 121ST ST, CLEVELAND, OH 44120-4302
(216) 526-3036
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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