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NPI Code Detail

MEDICARE: MICHELLE BERTMAN LSW

MEDICARE: MICHELLE BERTMAN LSW
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 WorkerS.0800894OH

General Provider Information

NPI Number : 1144500703
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BERTMAN LSW
Provider Business Mailing Address
First Line : 9083 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6462
Country : US
Telephone Number : 440-205-2674
Fax Number :
Provider Business Practice Location Address
First Line : 9083 MENTOR AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-6462
Country : US
Telephone Number : 440-205-2674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 08/26/2011

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Directions to “ MICHELLE BERTMAN LSW” Practice Location

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