Individual
CHANEICE EZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 E 119TH ST, CLEVELAND, OH 44120-2117
(216) 314-1106
Mailing address
2811 E 119TH ST, CLEVELAND, OH 44120-2117
(216) 314-1106
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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