Healthcare Provider Details

I. General information

NPI: 1396454518
Provider Name (Legal Business Name): SANDRA KESSEL-ENDRES NBC-HWC, E-RWT 500
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 W 25TH ST APT 621
CLEVELAND OH
44113-4151
US

IV. Provider business mailing address

2075 W 25TH ST APT 621
CLEVELAND OH
44113-4151
US

V. Phone/Fax

Practice location:
  • Phone: 610-559-4739
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: