Healthcare Provider Details

I. General information

NPI: 1467371351
Provider Name (Legal Business Name): ANITRA BRASFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1284 SOM CENTER RD STE 355
MAYFIELD HEIGHTS OH
44124-2048
US

IV. Provider business mailing address

1284 SOM CENTER RD STE 355
MAYFIELD HEIGHTS OH
44124-2048
US

V. Phone/Fax

Practice location:
  • Phone: 440-317-1985
  • Fax:
Mailing address:
  • Phone: 440-317-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.008118
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: