OrganizationActive
Ohioguidestone
NPI 1609123728 · Developmental - Behavioral Pediatrics Physician · Berea, OH
Provider details
- NPI number
- 1609123728
- Entity type
- Organization
- Primary specialty
- Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Mandy Jackson, Billing Supervisor
Mailing address
434 Eastland Road
Berea, OH 44017-2058
Registry dates
- Enumerated
- 2012-08-08
- Last updated
- 2017-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.