Individual
SHEVONNE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11219 NELSON AVE, CLEVELAND, OH 44105-4349
(216) 816-5504
Mailing address
11219 NELSON AVE, CLEVELAND, OH 44105-4349
(216) 816-5504
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
TN765125
OH
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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