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Individual

MRS. GLENDA ALISE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13514 KELSO AVE, CLEVELAND, OH 44110
(216) 925-6559
Mailing address
13514 KELSO AVE, CLEVELAND, OH 44110
(216) 925-6559

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
375268750696
OH

Other

Enumeration date
05/29/2008
Last updated
05/11/2026
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