Healthcare Provider Details

I. General information

NPI: 1326146465
Provider Name (Legal Business Name): NANCY LU ADAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD. .
CLEVELAND OH
44106
US

IV. Provider business mailing address

6541 KINGSWOOD DR
MAYFIELD HTS OH
44124-4227
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax: 216-707-6401
Mailing address:
  • Phone: 216-791-3800
  • Fax: 216-707-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3225
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: