Individual
CHAZ HENNESSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16808 MADISON AVE APT 1, LAKEWOOD, OH 44107-5419
(216) 209-4404
Mailing address
4400 EUCLID AVE, CLEVELAND, OH 44103-3734
(216) 431-5800
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
06/03/2025
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