Individual
ANN COOK VAN DE WALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
5905 BRECKSVILLE RD, INDEPENDENCE, OH 44131-1517
(216) 524-4673
Mailing address
3063 FOREST DR, CLEVELAND, OH 44124-5125
(216) 544-4751
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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