MEDICARE: DONYALE STANLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		OH

General Provider Information

NPI Number	:	1053140186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONYALE STANLEY

Provider Business Mailing Address
First Line	:	3417 E 105TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-5643
Country	:	US
Telephone Number	:	216-513-9043
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 E 105TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-5643
Country	:	US
Telephone Number	:	216-513-9043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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Directions to “ DONYALE STANLEY ” Practice Location

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