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General NPI Number Information
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NPI Number | 1124972237
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Entity Type | Individual
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Provider Name | KALVIN D RIDDLE LASH
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Gender | Male
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 11401 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5428
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Country | US
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Telephone | 216-416-4277
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Fax |
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Provider Business Mailing Address
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Address Line | 25731 CANDLEWICK CT
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City | WESTLAKE
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State | OH
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Zip | 44145-1475
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Country | US
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Telephone | 216-704-6359
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 512265
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License Number State | OH
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