Individual
MS. OLYRIA A VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2490 LEE BLVD, CLEVELAND, OH 44118-1268
(216) 600-5194
Mailing address
12701 SHAKER BLVD APT 216, CLEVELAND, OH 44120-2083
(330) 775-8660
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
94732158789
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94732158789
—
OH
Enumeration date
03/07/2019
Last updated
03/07/2019
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