Jacqueline Jo Ann Bertolette
Homemaker in Willoughby, OH. Individual provider (NPI-1).
NPI number1245073899
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1245073899
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Jo Ann Bertolette
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 376J00000X | Homemaker | RJ670249 | OH | Yes |
Practice location
38614 Plains CtWilloughby, OH 44094-7157
Phone 440-364-7371
Mailing address
38614 Plains CtWilloughby, OH 44094-7157
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