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General NPI Number Information
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NPI Number | 1114358223
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Entity Type | Individual
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Provider Name | VANESSA PATTERSON LMT.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2013
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Last Update Date | 11/29/2013
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Provider Practice Location Address
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Address Line | 7519 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-5434
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Country | US
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Telephone | 440-882-6985
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Fax |
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Provider Business Mailing Address
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Address Line | 3084 LIVINGSTON RD APT 2
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City | SHAKER HTS
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State | OH
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Zip | 44120-3261
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Country | US
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Telephone | 216-694-1966
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 33.017281 N-R
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License Number State | OH
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