Provider First Line Business Practice Location Address:
1440 LAKESIDE AVE
Provider Second Line Business Practice Location Address:
(PSYCHOLOGICAL SERVICES)
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-523-8498
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2014