Individual
WENDY S MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 233-7232
Mailing address
419 BOUNTY WAY, AVON LAKE, OH 44012-2400
(216) 401-1885
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
383638
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
OH
Enumeration date
05/11/2021
Last updated
05/11/2021
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