Individual
JESSICA TIEZ DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3719 E 110TH ST, CLEVELAND, OH 44105-2444
(216) 424-0579
Mailing address
3719 E 110TH ST, CLEVELAND, OH 44105-2444
(216) 424-0579
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400177731102
OH
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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