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NPI Code Detail

MEDICARE: RITA BRYCE LISW

MEDICARE: RITA BRYCE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerI.1700627-SUPVOH

General Provider Information

NPI Number : 1427487404
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA BRYCE LISW
Provider Business Mailing Address
First Line : 16500 PARKLAND DR
Second Line :
City : SHAKER HTS
State : OH
Zip : 44120-2539
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19910 MALVERN RD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44122-2823
Country : US
Telephone Number : 216-272-6970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2013
Last Update Date : 01/09/2026

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Directions to “ RITA BRYCE LISW” Practice Location

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