Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | OR |
NPI | 1093296006 |
---|---|
Provider Name | Miss Laura Stephanie Mourino |
First Address | Cleveland Heights, OH 44106-3188 |
Second Address | Cleveland Heights, OH 44106-3188 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |