Individual
DIANNE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17012 WALDEN AVE, CLEVELAND, OH 44128-1544
(216) 322-6563
Mailing address
PO BOX 201922, CLEVELAND, OH 44120-8115
(216) 322-6563
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
OH
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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