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Individual

MRS. LATORIA CHAVELL WEAVER-SPAULDING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5440 CHAMPION CREEK BLVD, MEDINA, OH 44256-6812
(330) 400-9269
Mailing address
5440 CHAMPION CREEK BLVD, MEDINA, OH 44256-6812
(330) 400-9269

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
253Z00000X
In Home Supportive Care Agency
7703999
OH
253Z00000X
In Home Supportive Care Agency
7703999
253Z00000X
In Home Supportive Care Agency
343900000X
Non-emergency Medical Transport (VAN)
7703999
3747P1801X
Personal Care Attendant
2409183
OH
3747P1801X
Personal Care Attendant
376J00000X
Homemaker
Primary
2409183
OH
376J00000X
Homemaker
385HR2050X
Respite Care Camp
7703999

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
770399
OH
05
7715155
OH
Enumeration date
06/03/2020
Last updated
12/02/2020
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