Individual
CHA CHA GWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10427 DETROIT AVE, CLEVELAND, OH 44102-1645
(216) 521-6511
(216) 521-6006
Mailing address
10427 DETROIT AVE, CLEVELAND, OH 44102-1645
(216) 521-6511
(216) 521-6006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2511806
OH
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/24/2021
Last updated
03/24/2026
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