Individual
ANNIETTRIA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCPRS
Contact information
Practice address
25201 CHAGRIN BLVD STE 390, BEACHWOOD, OH 44122-5637
(216) 910-9015
(216) 910-9015
Mailing address
14910 ELM AVE, EAST CLEVELAND, OH 44112-2613
(216) 235-1346
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0002361
OH
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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