Individual
KELLY MCCLOSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11225 ALEXA DR, CONCORD TWP, OH 44077-8557
(440) 289-9231
Mailing address
11225 ALEXA DR, CONCORD TWP, OH 44077-8557
(440) 289-9231
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2755362
—
OH
Enumeration date
05/30/2016
Last updated
07/17/2020
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