Provider Demographics
NPI:1942711221
Name:MARTIN-BABALOLA, CARLA L
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:L
Last Name:MARTIN-BABALOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3492 W 120TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3536
Mailing Address - Country:US
Mailing Address - Phone:216-280-5260
Mailing Address - Fax:
Practice Address - Street 1:3492 W 120TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3536
Practice Address - Country:US
Practice Address - Phone:216-280-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker