Individual
TAEKWONDA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24411 MAVEC AVE, EUCLID, OH 44123-2415
(216) 358-5074
Mailing address
24411 MAVEC AVE, EUCLID, OH 44123-2415
(216) 358-5074
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401332151211
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
401332151211
OHIO STATE TESTED NURSE AIDE
OH
Enumeration date
07/12/2018
Last updated
07/12/2018
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