Individual
GRACE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1830 W 28TH ST, CLEVELAND, OH 44113-3064
(440) 986-0360
Mailing address
1400 KINGSWAY, WESTLAKE, OH 44145-2613
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86174599
OH
Other
Enumeration date
05/15/2022
Last updated
12/05/2024
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