Individual
MARY MARGARET MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 641-2316
Mailing address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 641-2316
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
S.2001592-TRNE
OH
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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