Healthcare Provider Details

I. General information

NPI: 1952365959
Provider Name (Legal Business Name): CARA L CUDDY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

2801 MARTIN LUTHER KING JR DR
CLEVELAND OH
44104-3815
US

V. Phone/Fax

Practice location:
  • Phone: 800-223-2273
  • Fax:
Mailing address:
  • Phone: 216-448-6400
  • Fax: 216-448-6026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4861
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: