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1447378443
BRENT ANTONY BASILE
LAKEWOOD, OH
NPI
1447378443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OH I.0700026)
Enumeration Date
2007-03-27
Last Update Date
2007-07-08
Business Address
Mr. BRENT ANTONY BASILE LISW
1629 ONONDAGA AVE
LAKEWOOD, OH 44107-4310
Phone number: 216-374-8382
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Mailing Address
Mr. BRENT ANTONY BASILE LISW
1629 ONONDAGA AVE
LAKEWOOD, OH 44107-4310
Phone number: 216-374-8382
Copy
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