Healthcare Provider Details

I. General information

NPI: 1992285969
Provider Name (Legal Business Name): DEVON GREER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 SMITH RD
BROOKPARK OH
44142-2026
US

IV. Provider business mailing address

4145 PATTON RD
CLEVELAND OH
44109-3539
US

V. Phone/Fax

Practice location:
  • Phone: 216-362-6391
  • Fax:
Mailing address:
  • Phone: 440-520-4850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: