Individual
TYCHELLE MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7600 WOODLAND AVE # F9, CLEVELAND, OH 44104-3087
(216) 240-0498
Mailing address
3265 E 147TH ST APT 11, CLEVELAND, OH 44120-4100
(216) 609-7152
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
UA880623
OH
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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