Individual
GENAVEIVE MARIE DEVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13377 SMITH RD, MIDDLEBURG HEIGHTS, OH 44130-7810
(440) 340-5558
Mailing address
4515 GRAND LAKE DR STE 101, BRUNSWICK, OH 44212-4590
(330) 391-2618
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0002926
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175T00000X
—
OH
Enumeration date
02/13/2023
Last updated
02/13/2023
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