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Individual

ARETHA TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6827 FORMAN AVE, CLEVELAND, OH 44105-1419
(216) 376-5050
Mailing address
6827 FORMAN AVE, CLEVELAND, OH 44105-1419
(216) 376-5050

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0175060
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0175060
OHIO DEPARTMENT OF MEDICAID
OH
Enumeration date
09/24/2016
Last updated
09/24/2016
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