Individual
SHAVONTAE R EASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
443 RICHMOND PARK W APT 617D, RICHMOND HEIGHTS, OH 44143-1895
(216) 256-9869
Mailing address
443 RICHMOND PARK W APT 617D, RICHMOND HEIGHTS, OH 44143-1895
(216) 256-9869
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.004857
OH
175T00000X
Peer Specialist
FPS.000138
OH
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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