Individual
MRS. KELLY JUSTINE LACROIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3968 W 146TH ST, CLEVELAND, OH 44111-4321
(216) 970-0316
Mailing address
3968 W 146TH ST, CLEVELAND, OH 44111-4321
(216) 970-0316
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400521390706
OH
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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