Individual
MRS. BETHENIA Y NOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5963 MAPLEWOOD RD, MAYFIELD HTS, OH 44124-1646
(216) 235-7252
Mailing address
5963 MAPLEWOOD RD, MAYFIELD HTS, OH 44124-1646
(216) 235-7252
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129327
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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