Provider Demographics
NPI:1306607536
Name:OKOLISH, BETH
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:OKOLISH
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 1:5855 MANCHESTER AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH LAWRENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44666-9756
Mailing Address - Country:US
Mailing Address - Phone:330-806-1132
Mailing Address - Fax:
Practice Address - Street 1:5855 MANCHESTER AVE NW
Practice Address - Street 2:
Practice Address - City:N LAWRENCE
Practice Address - State:OH
Practice Address - Zip Code:44666-9756
Practice Address - Country:US
Practice Address - Phone:330-806-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist