Individual
KIMBERLEY MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1915 TEMBLETHURST RD, SOUTH EUCLID, OH 44121-3715
(216) 513-5506
Mailing address
1915 TEMBLETHURST RD, SOUTH EUCLID, OH 44121-3715
(216) 513-5506
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
1831570
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000269518
OHIO SHARED SERVICES SUPPLIER ID
OH
01
—
1831570
DODD CONTRACT NO.
OH
Enumeration date
09/14/2020
Last updated
09/14/2020
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