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Individual

ERICA INNOCENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11801 BUCKEYE, CLEVELAND, OH 44120
(216) 831-2255
Mailing address
3737 LANDER RD, CLEVELAND, OH 44124-5712

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1430088
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2871101
OH
Enumeration date
04/03/2014
Last updated
04/03/2014
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