Individual
ANTENISHA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 E 193RD ST, CLEVELAND, OH 44117-1373
(216) 563-2598
Mailing address
2889 E 111TH ST, CLEVELAND, OH 44104-4803
(216) 310-3498
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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