Individual
MICHELLE MOMIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9560 BROOKSIDE RD, INDEPENDENCE, OH 44131-6621
(216) 524-7379
Mailing address
4232 W 56TH ST, CLEVELAND, OH 44144-1848
(216) 272-6735
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198096
—
OH
Enumeration date
09/24/2020
Last updated
09/24/2020
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