Individual
JEANINE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9220 MENTOR AVE, MENTOR, OH 44060-6412
(440) 354-9924
Mailing address
1866 MANNERING RD, CLEVELAND, OH 44112-1571
(216) 288-9848
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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