Healthcare Provider Details
I. General information
NPI: 1558476895
Provider Name (Legal Business Name): BARBARA ANN EADY L.I.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 SEVERANCE CIR
CLEVELAND HEIGHTS OH
44118-1533
US
IV. Provider business mailing address
1001 LAKESIDE AVE E #1200
CLEVELAND OH
44114-1158
US
V. Phone/Fax
- Phone: 216-621-5600
- Fax: 216-479-5554
- Phone: 216-621-5600
- Fax: 216-479-5554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | I-0003758 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: