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1215541362
JACQUESE LYNNETTE SOUTHERN
CLEVELAND, OH
NPI
1215541362
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: OH C.2002631)
Enumeration Date
2020-09-06
Last Update Date
2020-09-06
Business Address
JACQUESE LYNNETTE SOUTHERN
12620 LARCHMERE BLVD
CLEVELAND, OH 44120-1110
Phone number: 216-543-0478
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Mailing Address
JACQUESE LYNNETTE SOUTHERN
18214 LA SALLE AVE # UP
CLEVELAND, OH 44119-2002
Phone number: 216-533-0478
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