Organization · Type 2 NPI
Enbodylife
Psychiatric/Mental Health Nurse Practitioner · Shaker Heights, OH
NPI number
1942079975
Active
Practice location
16808 Chagrin Blvd
Shaker Heights, OH 44120-3724
Fax (216) 415-6858
Mailing address
1408 S Green Rd
South Euclid, OH 44121-3920
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center | 261Q00000X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
About NPI 1942079975
Enbodylife's National Provider Identifier is 1942079975, issued on Jan 2, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Shaker Heights, OH. The record was last updated on May 27, 2025.