Provider Demographics
NPI:1942790563
Name:NUDEL, MARIANNA (TO, QMHS)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:NUDEL
Suffix:
Gender:F
Credentials:TO, QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20600 CHAGRIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5327
Mailing Address - Country:US
Mailing Address - Phone:216-751-5010
Mailing Address - Fax:
Practice Address - Street 1:20600 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5327
Practice Address - Country:US
Practice Address - Phone:216-751-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator