Individual
DOMONIQUE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MLS, PBT
Contact information
Practice address
757 ALPHA DR STE C, HIGHLAND HEIGHTS, OH 44143-2173
(347) 867-1188
Mailing address
3636 E 151ST ST APT 1, CLEVELAND, OH 44120-5172
(347) 867-1188
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
253352
OH
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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