Individual
JACQUELINE CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3471 E 78TH ST, CLEVELAND, OH 44127-2018
(216) 570-7869
Mailing address
3471 EAST 78TH STREET, CLEVELAND, OH 44127
(216) 570-7869
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
401053050310
OH
376K00000X
Nurse's Aide
Primary
401053050310
OH
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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