Individual
SOLEDAD JUSTINE LEOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
151 WINTHROP DR, ELYRIA, OH 44035
(440) 506-5785
Mailing address
151 WINTHROP DR, ELYRIA, OH 44035
(440) 506-5785
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
402160170419
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114
—
OH
Enumeration date
05/02/2022
Last updated
05/02/2022
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