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Individual

MS. ISABELLA-BLUE HEADLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 204-4315
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 204-4315

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1201567
OH

Other

Enumeration date
10/08/2018
Last updated
10/08/2018
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