Individual
COLEEN MACIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9220 MENTOR AVE, MENTOR, OH 44060-6412
(440) 953-8255
Mailing address
9220 MENTOR AVE, MENTOR, OH 44060-6412
(440) 953-8255
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864093
—
OH
Enumeration date
05/16/2023
Last updated
05/16/2023
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