Search › Ohio › 101Y00000X
Jacquese Southern
NPI 1215541362 · on the registry since 2020
Practice
- Address
- 12620 Larchmere Blvd
Cleveland, OH 44120 - Phone
- (216) 543-0478
- Organisation at this address
- Larchmere Center For Well-Being Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 8
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-09-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio