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Individual

KIMBERLEY M CLOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6854 SAVANNAH DR, NORTH RIDGEVILLE, OH 44039-2930
(440) 219-4135
Mailing address
2675 E 130TH ST, CLEVELAND, OH 44120-1451
(937) 902-1639

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker
Primary
374U00000X
Home Health Aide
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
OH
Enumeration date
07/20/2022
Last updated
04/30/2026
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