Individual
MARY CELESTINE HALL MENNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 286-6260
Mailing address
8055 MAYFIELD RD, STE 105, CHESTERLAND, OH 44026-2447
(440) 214-8027
(216) 201-8173
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35.090550
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225208
UNISON
OH
01
—
000000538617
ANTHEM
OH
05
—
1024582290001
—
PA
05
—
2770943
—
OH
01
—
421799
WELLCARE MEDICAID
OH
01
—
9731098
AETNA
OH
Enumeration date
09/26/2007
Last updated
12/05/2020
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