Elaine Marie Nelson, Cosmetic Therapist
Technician, Other in Mentor, OH. Individual provider (NPI-1).
NPI number1164053385
StatusActive
Last updated in NPPESJan 27, 2020
Details
- NPI
- 1164053385
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Elaine Marie Nelson
- Credential
- Cosmetic Therapist
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 27, 2020
- Certification date
- Jan 27, 2020
- Last updated
- Jan 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | 32.012312 | OH | Yes |
Practice location
Cosmetic Laser INC8353 Mentor Ave. Unit 7
Mentor, OH 44077
Phone 440-477-4074
Mailing address
5822 Woodhill StPainesville, OH 44077-5167
Phone 440-477-4074
Other practice locations
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