Individual
MRS. EQUILLIA FORTE-MOSTELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1629 IVYDALE RD, CLEVELAND HTS, OH 44118
(216) 288-6137
Mailing address
1629 IVYDALE RD, CLEVELAND HTS, OH 44118
(216) 288-6137
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078201
—
OH
Enumeration date
03/16/2020
Last updated
11/25/2020
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