Individual
KELLY MARIE MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 441-0200
Mailing address
8411 BROADWAY AVE, CLEVELAND, OH 44105-3932
(216) 441-0200
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1013699933
OH
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/01/2023
Last updated
04/02/2026
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