Individual
MARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3306 CYPRESS AVE, CLEVELAND, OH 44109-4935
(216) 862-1039
Mailing address
3306 CYPRESS AVE, CLEVELAND, OH 44109-4935
(216) 862-1039
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
0082805
OH
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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