Individual
MS. FATISHA LARCENIA MALIK OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3861 E 153RD ST, CLEVELAND, OH 44128-1111
(216) 386-6895
Mailing address
3861 E 153RD ST, CLEVELAND, OH 44128-1111
(216) 386-6895
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.144072-M-IV
OH
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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