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Individual

MRS. JACQUELINE ANNE MOHEISEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RRT

Contact information

Practice address
29728 PHILLIPS AVE, WICKLIFFE, OH 44092-2212
(440) 585-2907
Mailing address
29728 PHILLIPS AVE, WICKLIFFE, OH 44092-2212
(440) 585-2907

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
1473
OH
2279C0205X
Critical Care Registered Respiratory Therapist
1473
OH
2279G1100X
General Care Registered Respiratory Therapist
1473
OH

Other

Enumeration date
07/17/2013
Last updated
07/17/2013
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