Provider Demographics
NPI:1821818683
Name:BRADEN, VIOLA
Entity type:Individual
Prefix:MRS
First Name:VIOLA
Middle Name:
Last Name:BRADEN
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 1:22470 SHORE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1610
Mailing Address - Country:US
Mailing Address - Phone:216-650-3222
Mailing Address - Fax:
Practice Address - Street 1:22470 SHORE CENTER DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1610
Practice Address - Country:US
Practice Address - Phone:216-650-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOSI001252174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty