Individual
KIM M. BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3666 W 159TH ST, CLEVELAND, OH 44111-5706
(216) 548-2980
Mailing address
3666 W 159TH ST, CLEVELAND, OH 44111-5706
(216) 548-2980
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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